Saline infusion sonohysterography (SIS) in postmenopausal vaginal bleeding

Purpose: To calculate diagnostic accuracy parameters of transvaginal ultrasonography (TVUSG), saline infusion sonohysterography (SIS) and hysteroscopy (H/S) according to pathologic tissue examination results in patients to whom hysteroscopic biopsy or fractional curettage were done because of postmenopausal vaginal bleeding for uterine cavity assesment.Metods: 47 patients referred to Adnan Menderes University Hospital, Obstetric and Gynecology Clinic because of postmenopausal bleeding, during January-July 2009 were included in our study, retrospectively. Uterine cavity biopsies were done by fractione curettage or hysteroscopic ways. Before these biopsies, TVUSG and SIS were done to all patients. TVUSG, SIS and H/S results were compared according to pathology reports. Sensitivity, spesificity, positive and negative predictive values were calculated.Results: Sensitivity, specificity, positive and negative predictive values of TVUSG for all intracavitary patologies are respectively 44.4%, 25%, 59.2%, 25,9%. Sensitivity, specificity, positive and negative predictive values of SIS for all intracavitary patologies are respectively 88.8%, 60.7%, 59.2%, 89.4%. Sensitivity, specificity, positive and negative predictive values of H/S for all intracavitary patologies are respectively 100%, 77.7%, 80% and 100%.Conclusion: In experienced hands SIS is a cost effective ,simple, and effective diagnostic metod in patients with postmenopausal bleeding. Also it is easy to learn, does not need anestesia, has low complication rate, tolarable diagnostic metod.Key words: Postmenopausal bleeding, TVUSG, Saline infusion sonohysterography, HisteroscopyCommunication Adress:1. Yrd. Doç. Dr. Selda Demircan SezerAdnan Menderes University Hospital, Obstetric and Gynecology Department, AYDIN-TÜRKİYEE-mail: seldemircan@mynet.com2. Dr. Sümeyra NergizAdnan Menderes University Hospital, Obstetric and Gynecology Department, AYDIN-TÜRKİYEE-mail: snergiz@adu.edu.tr