Diagnostic efficacy of saline infusion sonohysterography and hysteroscopy for intrauterine lesion / 대한산부인과학회지

OBJECTIVE: To compare the diagnostic accuracy and acceptability of saline infusion sonohysterography (SIS), and hysteroscopy for detecting intracavitary abnormalities in women with abnormal uterine bleeding. METHODS: Seventy-eight patients with abnormal uterine bleeding were selected from the Department of Obstetrics and Gynecology in Chonnam University Hospital. The findings at SIS were compared with the hysteroscopic and histologic findings. The agreement of diagnosis between SIS and hysteroscopy was calculated. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: SIS had a sensitivity of 84% and a specificity of 85% for a diagnosis of endometrial polyp. Hysteroscopy had a sensitivity of 86% and a specificity of 96% for diagnosis of endometrial polyp. SIS had a sensitivity of 75% and a specificity of 86% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 99% for a diagnosis of submucosal myoma. SIS had a sensitivity of 91% and a specificity of 96% for a diagnosis of submucosal myoma. Hysteroscopy had a sensitivity of 100% and a specificity 91% for a diagnosis of endometrial hyperplasia. CONCLUSIONS: The diagnostic accuracy of SIS was significant to that of hysteroscopy in diagnosing intracavitary abnormalities, Moreover, SIS in a safe, convenient, cost effective, easily accessible and acceptable investigative modality.

A clinical study of vaginal myomectomy / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the clinical effectiveness and safety of vaginal myomectomy via colpotomy with analyzing clinical course and postoperative complication. METHODS: A retrospective study was performed in 59 patients, who underwent vaginal myomectomy between November 1997 and July 2006 in department of gynecology, Chonnam National University Hospital. Operating time, hemoglobin change, postoperative pain, perioperative complication, and days of hospital stay were recorded. RESULTS: Fifty-nine patients were evaluated, mean age of patients was 41.54+/-5.8 years. Mean diameter of the uterine myoma was 6.79+/-1.75 cm. Mean operating time was 66.69+/-34.49 minute. Mean hemoglobin loss was 2.67+/-1.26 g/dL, and mean days of hospital stay was 4.91+/-1.25 days. One patient had febrile morbidity. Only one patient had suffered from retroperitoneal bleeding enough to get on operation. CONCLUSION: Vaginal myomectomy seems to be a feasible and safe surgical procedure. Further randomised studies are needed to compare this procedure with laparotomy and laparoscopy, and vaginal myomectomy is expected to be more effective and generalized surgical procedure.