Sonohysterography

Chapter 250 Sonohysterography



DESCRIPTION


Sonohysterography is a technique of ultrasonographic visualization of the uterine cavity using saline as a contrast and distending media. The technique is also known as saline infusion sonohysterography (SIS).



INDICATIONS


Similar to those for hysteroscopy or endometrial biopsy; dysfunctional uterine bleeding, postmenopausal bleeding, menorrhagia, infertility (selected cases), or recurrent abortion, endometrial or pelvic infections (e.g., tuberculosis), missing intrauterine contraceptive device, or other situations where viewing the endometrial cavity can establish a diagnosis. The technique is particularly adept at documenting endometrial polyps, submucous leiomyomata, and intrauterine adhesions.



CONTRAINDICATIONS


Acute bleeding; acute cervical, uterine, or pelvic infection; known uterine or cervical cancer; pregnancy (known or suspected); recent uterine perforation; vaginitis (relative).



REQUIRED EQUIPMENT



• Sterile gloves

• Operating vaginal speculum (open sided)

• Skin preparation materials (generally an iodine-based antibacterial solution such as Betadine)

• 30 to 50 mL warmed sterile saline

• 30-mL syringe

• Intrauterine insemination catheter (e.g., Soules), sonohysterography catheter (e.g., Goldstein), thin balloon-tipped catheter, or small-gauge (5F) pediatric feeding tube (or similar)

• Sterile ring forceps or uterine packing forceps (optional)

• Lidocaine (1%) without epinephrine, syringe and 22- to 25-gauge spinal (4″) needle or lidocaine spray (optional)

• Appropriate ultrasonographic equipment and probe (abdominal and/or vaginal probe)


TECHNIQUE


When possible, sonohysterography should be performed during the proliferative phase of the menstrual cycle when the endometrium is thinnest. The discomfort of sonohysterography may be decreased by premedicating with a single oral dose of a nonsteroidal anti-inflammatory agent given in doses usually used to treat dysmenorrhea.

Related posts:

  1. Anemia
  2. Toxic Shock Syndrome
  3. Uterine Anomalies: Bicornuate, Septate, and Unicornuate Uterus
  4. Cervical Cancer

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Sonohysterography

Full access? Get Clinical Tree
Get Clinical Tree app for offline access