|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Device for hysterosonographyFrom: Spnglr@aol.comTue Dec 2 07:51:28 1997
Dear Karen, I have been involved in literally hundreds of sonoHSG ( aka hysterosonography; saline infusion sonography; sonohysterography) examinations over the past 3-4years. The debate is typically whether to use a straight vs a balloon catheter. My personal recommendation is an HS balloon catheter. ( several on the market: Akrad, which is what I use; Cook has one; and others) The balloon can be placed in the cervix rather than the lower uterine segment. This will alleviate the concern of uterine cramping upon balloon inflation and keeps the balloon out of the field of view during the exam. A patulous or multiparous cervix may not hold the balloon, in which case placement in the LUS may be necessary. Partial inflation of the balloon, slowly, typically causes little discomfort to the patient. (remember to use saline rather than air to inflate the balloon) Benefit of using the balloon catheter is that there is no leakage of saline back through the cervix. Dependent upon your target population, the balloon may not be necessary, in which case you simply do not inflate it. (post-menopausal; stenotic cx;etc.) The literature is full of creative "devices" used for this procedure: pediatric feeding tubes; small gauge foley catheters; insemination caths; etc. Cook has recently introduced the "Goldstein" catheter ( named after sonoHSG guru Steven Goldstein,M.D.) which has a movable "acorn" which is placed at the external os of the cx to decrease backflow. I have not tried that one yet. I have been quite pleased with the balloon. A few extra tips, quickly: - Use a single hinge (side opening) speculum; much easier to remove after catheter placement. - Flush the catheter w/saline to alleviate air artifact. - Inject saline slowly. This causes less cramping as well as alleviates air artifact. - Do not use large calliber syringe (>20ml) It produces more pressure. - If you premedicate, use an analgesic w/ a muscle relaxant. I am happy to help if you need more info. Nancy A. Spangler, RDMS, CNMT Milwaukee, WI, USA
|
|
Return to
|
Mail a New Message to the Forum: ultrasound@obgyn.net Forum Administrator: terry.dubose@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Mon Nov 2 05:38:25 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.