Hysterosonography: a key to what is inside the uterus

The pursuit of endometrial histology is often prompted by postmenopausal or dysfunctional endometrial bleeding, a pathologically-thickened central endometrial complex on ultrasound, infertility, or routine screening caused by risk factors for underlying pathology. If a focal endoluminal process is responsible, it can remain undiagnosed when a blind method of biopsy is used. Transvaginal ultrasound coupled with hysterosonography can provide the necessary information to triage these patients to the most appropriate tissue sampling technique and avoid the common problem of a false-negative biopsy result. In many circumstances, a focal process can be more specifically characterized and localized during hysterosonography, information which could also help direct subsequent hysteroscopic biopsy if needed.