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Fertil Steril. 2003 Apr;79(4):998-1002.

Use of strict sonohysterographic methods for preoperative assessment of submucous myomas.

Author information

1
Department of Obstetrics and Gynecology, Clinical Sciences Institute L Sacco, University of Milan, Milan, Italy. fpgleone@libero.it

Abstract

OBJECTIVE:

To assess the diagnostic accuracy of sonohysterography (SHG) and transvaginal sonography versus diagnostic hysteroscopy in preoperative assessment of submucous myomas.

DESIGN:

Prospective pilot study.

SETTING:

University hospital outpatient center.

PATIENT(S):

Forty-eight symptomatic (bleeding, infertility) premenopausal patients with submucous myomas.

INTERVENTION(S):

Preoperative grading of submucous myomas with a strict SHG methodology and standard transvaginal sonography compared with hysteroscopic grading of submucous myoma before hysteroscopic myomectomy.

MAIN OUTCOME MEASURE(S):

SHG and sonographic agreement with hysteroscopic findings.

RESULT(S):

Forty-eight patients were enrolled (mean age +/- SD = 41 years +/- 10.2). The median duration of SHG was 12 minutes (interquartile range, 9-16). The mean number of submucous myomas was 1 (range, 1-3) per woman. In all cases, a successful SHG was performed, with no, mild, or moderate pain in 38 (79%), 8 (17%), and 2 (4%) patients, respectively. No patients experienced severe pain or vasovagal reaction. All cases were correctly diagnosed by SHG compared with the final hysteroscopic diagnosis (kappa = 1.0; SE = 0.105). Simple transvaginal ultrasound was inaccurate in six cases (kappa = 0.81; SE = 0.103).

CONCLUSION(S):

Strict and reproducible SHG diagnostic procedures proved to be as effective as hysteroscopy and well tolerated in preoperative grading of submucous myomas.

PMID:
12749444
[Indexed for MEDLINE]
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