Diagnostic value of hysteroscopy and hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women

Objective To estimate the diagnostic value of hysteroscopy and hysterosonography in endometrial pathologies in asymptomatic postmenopausal women. Materials and methods In this prospective study, 77 asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. The patients underwent transvaginal ultrasonography and hysterosonography. All patients then had office diagnostic hysteroscopy or operative hysteroscopy. The final diagnosis was made by operative hysteroscopy with resection and excision of the lesions or endometrial biopsy with vacuum curettage. Sensitivity, specificity, positive predictive value and negative predictive value of transvaginal ultrasonography, hysterosonography and diagnostic hysteroscopy were calculated. Results The patients' age ranged from 45 to 80. The most common frequent abnormalities were endometrial hyperplasia in transvaginal ultrasonography (62.33%), endometrial polyp in sonohisterography (57.14%), and also endometrial polyp in diagnostic hysteroscopy (51.94%). Transvaginal ultrasonography revealed a sensitivity of 59.7% and a specificity of 35.5%. Sonohysterography revealed a sensitivity of 88.8% and a specificity of 84.4%. Diagnostic hysteroscopy revealed a sensitivity of 91% and a specificity of 82%. Conclusion Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of endometrial abnormalities in asymptomatic postmenopausal women. In asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography should undergo both hysterosonography and hysteroscopy.