Each gynecologist must have knowledge of the anatomy of the female reproductive system in order to be able to determine its individual characteristics in a particular case. This is a condition for the correct conduct of various diagnostic, therapeutic manipulations.
The concept of uterine sounding
The doctor receives information about the condition of the internal genital organs of a woman during a bimanual examination, ultrasound, and manipulations in the uterine cavity.
To determine the main parameters of the uterine cavity - depth, position in the pelvic cavity, use sounding. It is carried out using a special gynecological instrument - a probe.
Indications and contraindications for cavity sounding
Probing of the uterus is necessary when:
- early termination of pregnancy;
- diagnostic curettage of the walls of the uterus with uterine bleeding ;
- removal of the cervix with tumors, malignant process;
- fusion of the walls of the cervical canal.
Manipulation is carried out with the goal of determining the length and shape of the uterine cavity, the presence of neoplasms of the body of the organ, partitions (Asherman's disease).
Contraindications for conducting uterine sounding - a desired pregnancy, inflammatory diseases of the external, internal genital organs, purulent discharge from the vagina, cervical cancer in the decay phase.
Instruments for probing the uterus. Manipulation technique
To make a sounding of the uterus, use special tools:
- mirrors of Sims or Cuzco;
- bullet tongs - 2 pieces;
- forceps, forceps, uterine probe;
- alcohol solution, iodine;
- sterile medical gloves;
- cotton gauze balls;
- sterile diapers;
- Geghar expanders;
It is also required to obtain the consent of the patient to this manipulation.
Uterine Probing Algorithm:
- Registration of information consent to the procedure.
- Preparing to use the basic tools.
- Sanitary treatment of the external genital organs of the patient.
- Treatment of hips skin of a woman with iodine solution
- Bimanual examination of the genitals.
- Insertion of a mirror into the vagina of a woman.
- Exposure, cervical alcohol treatment.
- Fixation of the anterior lip of the cervix with bullet forceps.
- Removing the mirror from the patient's vagina.
- Insertion of the uterine probe into the uterine cavity without effort.
- Determination of the state of the cervical canal.
- Fixation of the length of the uterine cavity (the probe advances in the cavity until the wall stops).
- Clarification of the position of the uterus, the presence of various obstacles to the probe in the uterus.
- The withdrawal of the probe from the uterine cavity.
- The transition to the next step of the ongoing diagnostic or therapeutic manipulation.
Interpretation of uterine sounding results. Complications after the procedure
When the probe passes through the cervical canal, it is possible to diagnose neoplasms, fusion of the walls, cicatricial changes.
The length of the uterine cavity during probing is determined using a mark on the uterine probe when the instrument reaches the bottom of the organ. This value is recorded in the intervention protocol. In the case of different lengths of the uterus at two points, its asymmetry is determined, and it is necessary to identify the cause of this process.
After the doctor has determined the length of the uterine cavity, with extreme caution, he begins to slide the device along all the walls of the organ. This is done to diagnose the presence of neoplasms of the uterine cavity, namely adenomyosis, polyps, adenomatous nodes.
Also, by probing the uterus, it is possible to determine the consistency of its walls. With a significant density of neoplasms, conclusions can be drawn about the presence of fibromyoma, with mild, suspected malignant disease of the uterus.
After probing the uterus, miserable blood discharge from the vagina can be observed, which ceases normally after 2 days. With continued, increased bleeding, changes in the patient's condition (general weakness, fever), you should immediately consult a specialist.
After probing the uterine cavity, complications may develop:
- perforation of the walls, which requires urgent surgical intervention;
- the formation of a false move with subsequent incorrect measurement of the length of the uterus;
- infection with the development of endometritis.