A feasibility study to evaluate pelvic peritoneal anatomy with a saline intraperitoneal sonogram (SIPS).
OBJECTIVE
To prove the safety and feasibility of evaluating pelvic anatomy with a new imaging technique called saline intraperitoneal sonogram (SIPS).


METHODS
Prospective clinical case series.


METHODS
Outpatient fertility clinic.


METHODS
Ten women with unexplained infertility and normal hysterosalpingograms (HSG). Five women with no known risk factors and five women with known risk factors for adhesive disease were enrolled.


METHODS
Step 1 required performing a sonohysterogram. Step 2 involved directing a 17-g oocyte retrieval needle into a pocket of peritoneal fluid under ultrasound guidance and infusing normal saline. The pelvic anatomy was evaluated with the three-dimensional and four-dimensional mode on pelvic ultrasound.


METHODS
Technical feasibility, safety, time, fluid infusion, and deficit volumes.


RESULTS
All 10 patients successfully completed the protocol. One of the five women with no risk factors for adhesive disease and a normal HSG was discovered to have a unilateral hydrosalpinx and filmy adhesive disease on SIPS. Both findings were confirmed on laparoscopy. Three out of the five women with known risk factors had abnormal SIPS imaging and were confirmed on laparoscopy to have significant adhesive disease. The average procedure time was 45 minutes (±15 minutes).


CONCLUSIONS
This study demonstrates that SIPS is a safe, quick, and potentially cost-effective method for evaluating pelvic adhesive disease in an outpatient facility in women with unexplained infertility and a normal HSG.
Shah
Anish A
AA
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27713, USA. anish.shah@duke.edu
Walmer
David K
DK
D000328:Adult; D001202:Ascitic Fluid / Q000000981:diagnostic imaging; D019160:Endosonography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007263:Infusions, Parenteral; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000473:pathology; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D010537:Peritoneum / Q000000981:diagnostic imaging* / Q000473:pathology; D012965:Sodium Chloride / Q000008:administration & dosage; D000267:Tissue Adhesions / Q000000981:diagnostic imaging
D012965:Sodium Chloride