Gel instillation sonohysterography: first experience with a new technique

ObjectiveA practical attempt to simplify and improve the technique of artificial uterine cavity distension by instilling gel instead of flushing saline.DesignProspective observational study.SettingTeaching hospital.Patient(s)One hundred twenty patients with an indication for sonohysterography (abnormal uterine bleeding, exclusion of congenital abnormalities, or preoperative or postoperative evaluation of submucous myomas, polyps, or synechiae).Intervention(s)A hydroxyethylcellulose gel containing anesthetic and antiseptic agents was instilled in the uterine cavity through a plastic intrauterine insemination cannula attached to a flexible plastic tube and a syringe. Transvaginal (3-dimensional) ultrasonography was performed concomitantly.Main Outcome Measure(s)Stable filling of the uterine cavity allowing a high-quality ultrasonographic visualization.Result(s)An optimal distension of the uterine cavity could be achieved with an average of only 4 mL (range, 2–10 mL) in 113 patients. As expected, a stable filling of the uterine cavity permitted a precise visualization of the uterine cavity and its linings and offered an optimal presentation for a 3-dimensional ultrasound recording and reconstruction.Conclusion(s)Gel instillation is a simple technique with minimal inconvenience for the patient and seems to be an attractive alternative to saline infusion during sonohysterography.