Gel instillation sonohysterography (GIS) and saline contrast sonohysterography (SCSH): comparison of two diagnostic techniques.
OBJECTIVE
To compare gel instillation sonohysterography (GIS) with saline contrast sonohysterography (SCSH) as diagnostic methods for the evaluation of the uterine cavity.


METHODS
A prospective cohort study was performed at the Department of Obstetrics and Gynecology of the VU University Medical Center, Amsterdam, between September 2007 and April 2008. We included 65 women suspected of having an intrauterine abnormality with an indication for SCSH/GIS. First SCSH and subsequently GIS were performed in all women. Distension of the uterine cavity, image quality, visualization of intrauterine abnormalities and pain experienced on a visual analog scale (VAS score) were recorded for both procedures.


RESULTS
The mean distension with GIS was 9.0 mm and with SCSH it was 8.5 mm (P = 0.15). The mean image quality, on a scale from 0 to 5, for SCSH was 4.0 and for GIS it was 3.6 (P = 0.01). No difference was found for the visualization of intrauterine abnormalities, and the VAS scores for pain experienced on SCSH and GIS were 1.5 and 1.6, respectively (P = 0.62).


CONCLUSIONS
The image quality of SCSH is slightly better than that of GIS. This difference is likely to be attributable to the presence of air bubbles in the gel. The small difference in uterine cavity distension in favor of GIS and comparable stable distension during at least 4 min make GIS a suitable alternative for SCSH if air bubbles can be prevented.
Bij de Vaate
A J M
AJ
Department of Obstetrics and Gynecology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. m.bijdevaate@vumc.nl
Brölmann
H A M
HA
van der Slikke
J W
JW
Emanuel
M H
MH
Huirne
J A F
JA
D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D005782:Gels; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D012965:Sodium Chloride; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D014599:Uterus / Q000000981:diagnostic imaging* / Q000473:pathology
D003287:Contrast Media; D005782:Gels; D012965:Sodium Chloride