title: Sonohysterography: is the hysterosalpingographic vacuum cup a valid alternative device for cannulation of the cervical Os?
abstract: OBJECTIVE
  To determine whether sonohysterography (SHG) should be performed with Plexiglas hysterosalpingographic vacuum cups instead of standard catheters.
  
  
  METHODS
  In a prospective setting, 226 women randomly classified into 2 groups underwent SHG. The method used for cervical cannulation was a two-way catheter in the first group (n = 108) and a Plexiglas hysterosalpingographic vacuum cup in the second one (n = 118). Diagnostic reliability, easy applicability for the physician, discomfort for the patients and cost of the instruments were assessed for both devices.
  
  
  RESULTS
  226/226 (100 %) complete sonohysterographic examinations were performed. As regards uterine cavity distension the same diagnostic reliability was reported for vacuum cups and two-way catheters. The standard catheter obscured the cervical canal because of the dilation of the balloon. Both methods were judged as easy to use, and no statistically significant difference was found as far as the time required for cervical cannulation (p > 0.05). A little more discomfort was recorded by women who underwent sonohysterography with standard balloon catheters but a greater interpersonal variability was noticed in this group (SD 3.65 vs. 1.13 in the vacuum cup group). Vacuum cups were by far the most economical devices (unit cost: 16.70 euro vs. catheter unit cost 46.20 euro).
  
  
  CONCLUSIONS
  Vacuum cups allow sonohysterography to be correctly performed. As they are inexpensive, easy to use, better tolerated by the patients and more helpful for visualisation of the lower third of the uterine cavity, vacuum cups should be considered a serious alternative to standard catheters in the performance of SHG.
authors.affiliation: Department of Radiological Sciences, Umberto I Hospital--La Sapienza University of Rome, Rome, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Porfiri
authors.forename: F M
authors.initials: FM
authors.lastname: Drudi
authors.forename: S
authors.initials: S
authors.lastname: Savelli
authors.forename: C
authors.initials: C
authors.lastname: de Felice
mesh_terms: D000328:Adult; D002404:Catheterization; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D004717:Endometrium / Q000000981:diagnostic imaging; D005187:Fallopian Tubes / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D014618:Vacuum