Comparison of diagnostic methods for evaluation of postmenopausal bleeding

To determine and compare diagnostic accuracy parameters of saline infusion sonohysterography (SIS), transvaginal ultrasonography (TVUSG), and hysteroscopy (H/S) based on histopathologic results which are accepted to be the gold standard in patients with postmenopausal bleeding (PMB).

Forty-seven patients who applied to Gynecology clinic of Adnan Menderes University, School of Medicine with PMB complaint aged between 43-76 years were included to the study. Fractioned curettage (F/C) and H/S guided biopsy were used for endometrial sampling. Diagnostic accuracy parameters (sensitivity, specificity, and positive and negative predictive values) of different methods; TVUSG, SIS, and H/S based on histopathologic findings were investigated.

Specificity and sensitivity values calculated based on histopathologic results for all endometrial cavity lesions were found, respectively: 44.4% and 25% for TVUSG, 88.8% and 60.7% for SIS, and 100% and 77.7% for HIS.

SIS is superior to TVUSG and as effective as H/S for assessment of endometrial cavity lesions in patients with PMB.