OP35.06: Saline sonohisterosalpingography as the main method of endometrial thickness assessment in HRT after menopause

Abstract

To evaluate the accuracy of the sonohisterosalpingography (SHG) comparing to usual transvaginal ultrasound scan in assessing the endometrial thickness of women who received HRT in menopause. We conducted a prospective study in which we compared the two methods of ultrasound scanning in 112 menopausal patients who received different HRT schemes. Women were placed in lithotomy position after urinary bladder evacuation. The first scan was a usual transvaginal one and the thickness was measured in sagittal section of the uterus. The largest measurement was noted. After that saline solution was instilled in uterus by mean of a thin catheter and again measurement of the endometrium was done. We measured the largest part of the endometrium in one layer. Endometrium that was larger than 5 mm after the saline instillation imposed biopsy and histological examination. 72 patients had endometrium larger than 5 mm after SHG comparing to 67 after plain TV scan. We found 6 cases of endometrial neoplasm and 21 of endometrial atypical hyperplasia. Histological findings showed a good correlation with the SHG findings—in 30 women with endometrial thickness over 8 mm there were found 4 cases of endometrial ADK and 16 of atypical hyperplasia. SHG is a excellent method of endometrial thickness assessment proving many advantages as good correlation with the histological findings, non invasive, uncomplicated and well tolerated.