Table 4 The descriptions of saline infusion sonography and office hysteroscopy
Saline infusion sonography | Office hysteroscopy |
|---|---|
In general | In general |
This procedure is used to determine the presence or absence of abnormalities in the uterine cavity. | This procedure is used to determine the presence or absence of abnormalities in the uterine cavity. Occasionally during this procedure, treatment will immediately follow a diagnosis. |
Description of procedure | Description of procedure |
The patient is seated in an examination chair with the legs resting on two knee supports. The doctor or investigator places a speculum in the vagina. A thin catheter (cross-sectional plane, 2Â mm) is inserted through the neck of the womb into the womb, through which sterile normal saline solution is injected. When filled, a vaginal ultrasound is performed. | The patient is seated on an examination chair with the legs resting on two knee supports. The doctor inserts a thin telescope (cross-sectional plane, 4Â mm) through the vagina and neck of the womb, into the womb (without using a speculum). Through the telescope, sterile saline solution is injected into the womb. Once the tip of the hysteroscope is in the womb, the inner wall is seen on a TV screen and can be evaluated. |
Duration of procedure | Duration of procedure |
15 min. Directly after the procedure, the patient may go home. | 15 min. If subsequent therapy is required, an additional 15–30 min. |
Directly after the procedure, the patient may go home. | |
Anaesthesia | Anaesthesia |
None | None |
Therapy | Therapy |
If an abnormality is found (50% of cases), a new appointment to treat it will be made. Depending on the type of abnormality, treatment will take place in the outpatient clinic by hysteroscopy (as described on the right). If this is not possible, treatment under general anaesthesia in the operating room may be required. | If an abnormality is found (50% of cases) in a part of the cases, the doctor will be able to remove it with a special instrument introduced through the telescope, e.g. removal of polyps or by taking biopsies for further analysis. If this is not possible, treatment under general anaesthesia in the operating room may be required. |
Risk | Risk |
Complications of SIS, 0.2% (1 out of 500; e.g. infection) | Complications of hysteroscopy, 0.4% (1 out of 250; e.g. infection, bleeding) |
Failure of procedure | Failure of procedure |
In 16% (16 out of 100) of the cases, the procedure will fail or will not provide enough information on the suspected pathology. In such cases, a new appointment will be made to perform a hysteroscopy in the outpatient clinic. | In 12% (12 out of 100) of the cases, the procedure will fail or will not provide enough information on the suspected pathology. In such cases, the hysteroscopy will be repeated under general anaesthesia in the operating room. |