A simple one-stop menstrual problem clinic with use of hysterosonography for the diagnosis of abnormal uterine bleeding

Background. The purpose of the present study was to evaluate a one-stop outpatient bleeding disorder clinic in a Scandinavian population. Methods. One hundred and fourteen women under the age of 60 years referred to the clinic for bleeding disorders. The consultation included pelvic ultrasound, hysterosonography and, when indicated, endometrial sampling. Results. In 93% of the patients a sufficient diagnosis of the uterine cavity was attained at a one-stop visit. Eighty-six percent of the patients were investigated according to the one-stop program, and in 73% of the patients a treatment plan could be formulated during the consultation. Twenty-one percent had selective resection of intracavitary abnormalities. In 3% no intracavitary abnormality was found at hysteroscopy, even though hysterosonography had indicated this. Conclusions. Most patients under the age of 60 with bleeding disorders can be investigated by a one-stop out-patient procedure with the use of hysterosonography and endometrial sampling. Diagnostic or operative hysteroscopy was needed in cases of insufficient hysterosonography and suspicion of intracavitary abnormalities. This procedure can assist in determining the therapeutic approach and can often lessen the extent of surgical intervention or obviate it altogether.