The endometrium overlying sessile lesions, such as submucous fibromyomas, is usually normal. The prevalence of endometrial carcinoma is higher in women in whom the endometrium is thicker than 5 mm. 5 TVS can, therefore, be used to determine which patients should undergo further investigation. Recent reports have demonstrated that filling the endometrial cavity with fluid allows improved detection and delineation of small endoluminal masses. The technique of TVHS is simple to perform and relatively painless.
Some patients complain of minor cramping during the saline instillation.
The major risks of performing TVHS are infection and perforation. In our series, one patient developed mild endometritis after the procedure. The additional cost of TVHS seems justified in view of the added information it provides. Fallopian tubal patency assessed by ultrasound following fluids injection. Endometrial assessment by vaginal ultrasonography before endometrial sampling in patients with post-menopausal bleeding.