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Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: Systematic review and meta-analysis

Ultrasound in Obstetrics & Gynecology Jun 17, 2019

Vroom AJ, et al. - In this systematic review, researchers examined saline contrast sonohysterography (SCSH) for its accuracy for diagnosis of endometrial polyps in women with postmenopausal bleeding. Searching MEDLINE, EMBASE and Web of Science databases, they included five studies following selection and quality assessment. They noted the pooled sensitivity of SCSH of 86.5% and the pooled specificity of 91.1% when ‘polyps diagnosed with histopathology’ were used as the reference standard. SCSH had the pooled sensitivity of 85.1% (95% CI, 66.9–100%) and the pooled specificity of 84.5% (95% CI, 68.1–100%) when ‘polyps seen on hysteroscopy’ were used as the reference standard. Outcomes suggest that SCSH examination can be used to stratify women with postmenopausal bleeding for further diagnostic workup and treatment with hysteroscopy when it is of optimal quality. They recommend considering expectant management in women without suspicion of a polypoid lesion on SCSH, and with a benign endometrial sample.
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