Is there a place for sonohysterobiopsy in the evaluation of endometrial pathologies in postmenopausal asymptomatic women with thickened endometrium?

Purpose: The aim of this study was o compare the diagnostic value of sonohysterobiopsy to a method involving saline infusion sonography followed by dilatation and curettage in detecting endometrial pathologies in postmenopausal asymptomatic women with an endometrial thickness greater than 5 mm. Materials and Methods: Asymptomatic postmenopausal women who were diagnosed by means of transvaginal ultrasonography with endometrial thickness greater than 5 mm were assigned to two diagnostic groups prior to hysteroscopy. The study group included patients who underwent sonohysterobiopsy (SHB) during saline infusion sonohysterography (SIS). The control group included patients who underwent SIS followed by dilatation and curettage (D&C). Results: In 35 patients (35%), at least one of the risk factors for endometrial malignancy was present. The histopathological evaluation of the specimens showed presence of a polyp in 40 (60%) patients who underwent SIS and D&C. SHB results were more concordant with the hysteroscopic findings compared to those of SIS and D&C. The cut-off value for the accurate diagnosis of an endometrial polyp with SHB was 10 mm, with a sensitivity of 96% and a specificity of 100%. Conclusion: Sonohysterobiopsy is an efficient and safe procedure with a high sensitivity and specificity for the diagnosis of endometrial pathologies.