In the management of abnormal uterine bleeding, is office hysteroscopy preferable to sonography? The case for hysteroscopy.

Office hysteroscopy for the diagnosis and management of abnormal uterine bleeding has developed into an easily performed procedure, with minimal discomfort and significantly reduced risks and expense. Miniaturization of instruments and safer liquid distention media, along with effective local analgesia, have made the procedure a fast, effective, and much more precise way to detect intrauterine abnormalities, as well as to better define the correct plan for any proposed operative management. In addition to the above, hysteroscopy is considered the "gold standard" for evaluating the uterine cavity. Numerous studies comparing hysteroscopy to sonography, with or without saline solution infusion are cited, along with other studies comparing hysteroscopy to blind biopsy and curettage, all indicating that hysteroscopy is more accurate, with fewer false-positive and false-negative results.