Seventeen studies (4,208 procedures) were included.
The quality scores ranged from 4 to 13 out of a maximum score of 14. The proportion of patients who received verification was 100% in 14 studies and 44 to 98% in the remaining 3 studies.
Diagnosis of intracavitary abnormalities (16 studies).
The sensitivity ranged from 84 to 100% and the pooled sensitivity was 94% (95% CI: 92, 95). There was no evidence of heterogeneity (p=0.37; I-squared 7.6%). The specificity ranged from 39 to 100% and the pooled specificity was 89% (95% CI: 87, 90). There was strong evidence of heterogeneity (p<0.001; I-squared 81.5%). The prevalence of uterine abnormalities was 46.6%. The only subgroup analysis in which heterogeneity was eliminated was for the 5 studies of postmenopausal bleeding. Pooled sensitivity and specificity for this subgroup were similar to the overall figures.
Endometrial polyps (12 studies).
The pooled sensitivity and specificity were 94% (95% CI: 92, 96) and 92% (95% CI: 91, 94), respectively. Ranges were not reported, neither were data on heterogeneity.
Submucous myomas (11 studies).
The pooled sensitivity and specificity were 87% (95% CI: 81, 92) and 95% (95% CI: 93, 97), respectively. Ranges were not reported, neither were data on heterogeneity.
The proportion of failed procedures was reported in 12 out of 17 studies and ranged from 0 to 17%; 7 studies reported 0 failed procedures. Complication rates were reported for 1,399 procedures and showed 16 complications: 13 vasovagal collapses, two false tracts and one perforation of the uterine wall.