Gel infusion sonography in the evaluation of the uterine cavity.
OBJECTIVE
To compare gel infusion sonohysterography (GIS) with saline contrast sonohysterography (SCSH) with regard to technical feasibility and procedure-related pain experienced by patients.


METHODS
This prospective observational cohort study included 551 consecutive patients with abnormal bleeding: SCSH was attempted in the first 402 women and GIS was attempted in the following 149. All procedures were performed by the same examiner, in the same clinical setting, using a 2-mm diameter catheter. After contrast sonohysterography, most patients underwent office hysteroscopy (n = 502) and endometrial sampling (n = 323). The women were asked to rate the pain experienced during each procedure using a 100-mm visual analog scale (VAS). Patients' characteristics, ultrasound findings, histological diagnosis, technical failures and procedure-related pain were compared between the two procedures.


RESULTS
The mean +/- SD VAS score for contrast sonography, subsequent hysteroscopy and endometrial biopsy were 22.9 +/- 21.7, 38.8 +/- 26.6 and 50.0 +/- 26.3, respectively, in the SCSH subgroup vs. 16.5 +/- 21.5, 27.6 +/- 28 and 33.6 +/- 30.3, respectively, in the GIS subgroup (P = 0.0051, P = 0.0005 and P = 0.0003, respectively). The technical failure rate was 5% in the SCSH subgroup vs. 2% in the GIS subgroup (P = 0.1522).


CONCLUSIONS
GIS and SCSH showed similar technical feasibility. The procedure-related pain reported by patients during contrast sonohysterography, as well as during subsequent hysteroscopy and endometrial sampling, was less in the GIS group.
Van den Bosch
T
T
Department of Obstetrics and Gynecology, University Hospitals, KU Leuven, Leuven, Belgium. thierry.van.den.bosch@skynet.be
Betsas
G
G
Van Schoubroeck
D
D
Daemen
A
A
Vandenbroucke
V
V
Cornelis
A
A
De Moor
B
B
Deprest
J
J
Timmerman
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003287:Contrast Media; D005260:Female; D005782:Gels; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging* / Q000473:pathology; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods; D014592:Uterine Hemorrhage / Q000209:etiology*; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
D003287:Contrast Media; D005782:Gels