The value of transvaginal sonography with and without saline instillation in the diagnosis of uterine pathology in pre- and postmenopausal women with abnormal bleeding or suspect sonographic findings.

In this prospective study, 139 patients, 83 premenopausal patients with abnormal uterine bleeding and 56 postmenopausal patients either with metrorrhagia (33) or a suspect sonographic finding (23), were examined preoperatively with transvaginal sonography (TVS) and saline contrast hysterosonography (SCHS). The histological results, obtained by hysteroscopy, were compared with the preoperative findings. Uterine pathology (benign polyps, submucous fibroids, endometrial hyperplasia and carcinoma) was found in 74.7% and 76.8% of the pre- and postmenopausal patients, respectively. TVS and SCHS are very sensitive at diagnosing uterine pathology, the latter being more specific and enabling better surgical management and a reduction in unnecessary interventions.