Routine use of hysterography in endometrial carcinoma and postmenopausal bleeding

Unexpected hysterographic findings were encountered in 42 of 105 patients with postmenopausal bleeding or endometrial carcinoma. These included the extent and location of tumor, size and position of the uterus, uterine perforations or fistulas, and undetected myomas, congenital defects, or adnexal pathology. The findings proved of sufficient value in clinical management that hysterography, using water soluble medium, has been adopted as a routine procedure in such cases, especially if radium or cesium packing is employed. There was no statistically significant correlation between the histologic grade of the tumor and the hysterographic appearance of well-circumscribed or diffusely infiltrating lesions. Intravasation of contrast media occurred in 9 patients, lymphatic uptake was observed in 8, and peritoneal spillage of dye in 31 patients. There was no significant morbidity, and results to date show no evidence of tumor spread from the procedure.