Rationale and objective
To describe the short-term clinical outcomes of women with postmenopausal bleeding
(PMB) who underwent saline-infused sonohysterography (SIS) and the impact of SIS results
on clinical management.
Materials and methods
A retrospective review of the Radiology Information Systems database identified 786
women who underwent SIS between February 1998 and October 2002. Of this group, 144
women (mean age, 60; range, 42–83) presented with PMB. The following clinical data
were extracted from the electronic medical record: date of birth, hormone replacement
therapy (HRT) status, SIS results, and clinical management before and after the SIS
procedure. We categorized post-SIS clinical management into three categories: additional
diagnostic or therapeutic procedure performed; HRT change or addition; or no change
in clinical management. Between-group comparisons were performed using a χ2 test.
Results
Of the 144 women with postmenopausal bleeding who underwent SIS, 119 (82.6%) successfully
completed the SIS. Eighty women (67.2%) had a positive SIS exam. Abnormalities detected
including polyps (n = 42); submucosal fibroids (n = 6); endometrial thickening (n = 8); a combination of 2 or more of the above (n = 7), or other abnormalities (debris, adenomyosis, or indeterminate findings, n = 17). Of the women with a positive SIS exam, 58% received subsequent diagnostic/therapeutic
procedures compared to 5% of women who had a negative SIS (P < 0.001). Conversely, 59% of women with a negative SIS had no change in clinical
management compared to 17.5% who had a positive SIS (P < 0.001).
Conclusion
The trend in short-term clinical management is to pursue more aggressive subsequent
diagnostic or treatment procedures if findings are positive on SIS. A negative SIS
exam was associated with more conservative management.
Key words
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Article info
Publication history
Accepted:
November 8,
2004
Received in revised form:
November 8,
2004
Received:
September 10,
2004
Footnotes
RCC was supported in part by the NIH/NCRR grant number K12 RR017607-01.
Identification
Copyright
© 2005 AUR. Published by Elsevier Inc. All rights reserved.
