Twenty-six studies, with 1,101 procedures (range 10 to 266), were included in the review.
The pooled detection rate was 78% (95% CI 73 to 84) and Ι² was 80% indicating substantial heterogeneity. Meta-regression indicated that hysteroscopic injection had a lower detection rate (p=0.045) and pericervical injection had a higher detection rate (p=0.031).
The pooled estimate of sensitivity was 93% (95% CI 85 to 100); Ι² was 16% indicating low heterogeneity. Meta-regression indicated that subserosal injection had lower sensitivity (p=0.049).
There was some evidence of significant small-study effects.