Transvaginal hysterosonography for differential diagnosis between submucous and intramural myoma

Thirty-six patients with hypermenorrhea, dysmenorrhea, and/or anemia were examined by transvaginal sonography (TVS) and by transvaginal hysterosonography using an endometrial balloon catheter and saline (TVHS). Those patients who showed distinct intramural myomas by TVS were excluded from this study. Of 36 patients, 22 were diagnosed with submucous myomas, 10 with intramural myomas, and 4 with endometrial polyps by TVS, but 20 patients were diagnosed as having submucous myomas, 12 patients intramural myomas, and 4 patients endometrial polyps by TVHS. The correlation between ultrasound findings and surgery (hysterectomy or hysteroscopy) indicated that there were 13 misdiagnoses (36%) by TVS and only one misdiagnosis (2.8%) by TVHS.