Document Detail


The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia.
MedLine Citation:
PMID:  9308809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To verify the reliability of transvaginal ultrasonography in diagnosing intrauterine disease and in evaluating the operability of submucous myomas and to determine the feasibility, acceptability and validity of hysteroscopy for menorrhagia, we performed a prospective 5 year study on 793 women of mean age +/- SD of 41.5 +/- 7.8 years. All the patients referred for excessive menstrual bleeding with uterine volume <12 week pregnancy who underwent complete physical examination, transvaginal ultrasonography and outpatient hysteroscopy with endometrial biopsy were included in the study. Outpatient hysteroscopy was not completed due to intolerance or was unsatisfactory due to excessive bleeding in 23 cases (2.9%). Only 28 women (3.5%) declared they would have refused the procedure had they imagined the pain involved. One case of pelvic infection was observed. Compared with hysteroscopy, transvaginal ultrasonography had 96% sensitivity, 86% specificity, 91% positive predictive value and 94% negative predictive value in the diagnosis of intrauterine abnormality. The sensitivity, specificity, positive and negative predictive values of ultrasonography in identifying submucous myomas operable hysteroscopically (intramural extension <50%) were respectively 80, 69, 83 and 65% with a k index of agreement between ultrasonography and hysteroscopy of 0.48. Thus, considering the good specificity and high negative predictive value, transvaginal ultrasonography may be suggested as the initial investigation in menorrhagic patients, limiting hysteroscopy to cases with positive or doubtful sonographic findings.
Authors:
P Vercellini; I Cortesi; S Oldani; M Moschetta; O De Giorgi; P G Crosignani
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  12     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1997 Aug 
Date Detail:
Created Date:  1997-11-20     Completed Date:  1997-11-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1768-71     Citation Subset:  IM    
Affiliation:
Clinica Ostetrica e Ginecologica Luigi Mangiagalli, University of Milan, Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Ambulatory Care / methods*
Biopsy
Evaluation Studies as Topic
Feasibility Studies
Female
Humans
Hysteroscopy*
Leiomyoma / diagnosis
Menorrhagia / diagnosis*,  ultrasonography
Middle Aged
Predictive Value of Tests
Pregnancy
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Uterine Neoplasms / diagnosis
Vagina

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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