3D/4D ultrasound
HyCoSy and HSN
Generally
Infertility affects approximately 10% of couples in modern developed countries. From 20 to 40% of them are the result of abdominal operations or after overcoming infections of the fallopian tubes, but which the patient does not necessarily know about. With respect to this diagnostic management leans in the first step towards minimal invasiveness and not to an immediate surgical intervention! Many works have been published, especially in Germany, the UK, the USA and Australia, confirming the comparable results of HyCoSy (Hysterosalpingo-contrast-sonography) with x-ray hysterosalpingography and laparoscopy. Therefore, HyCoSy in modern gynecological diagnostics is the first choice with suspected impassability of the fallopian tubes and is considered to be the gold standard.
As with other imaging techniques even with ultrasound it isn’t possible to see everything and this imaging method also has its limitations. Sometimes instilling the gel into the cavity of the uterus - hysterosonography HSN helps us overcome these limitations and improves the imaging of the endometrium (the uterine lining), on which polyps or other serious pathological changes can be identified.
When?
We carry out both diagnostic modalities most often in the follicular phase of the menstruation cycle, i.e. in the first 10 to 14 days. HSN also becomes and obligatory examination in the planning of reproduction of the mother after two Caesarean sections.
How?
HyCoSy (so-called HyFoSy) is a contrasting transvaginal ultrasound technique, during which we use a contrasting gel/foal (ExEm Foam®), where the passage of this gel through the fallopian tubes is observable under ultrasound and subsequently evaluated. With ultrasound examinations of the passability of the fallopian tubes we use 2D and 3D/4D imaging.
Hysterosonography – HSN is a new technique, created for better ultrasound imaging of the uterine cavity. A sterile gel is applied using a soft plastic catheter placed in the cervix. The gel expands the cavity and enables it to be much better imaged by the transvaginal ultrasound. This technique is used for assessing CBD and other abnormalities of the uterus and endometrium.
What is it for?
The advantages and safety of HyCoSy are now in the front line of examination of female infertility and thus it is preferred over x-ray hysterosalpingography and laparoscopy. HyCoSy also enables examination of other pelvic organs, and therefore it is a dynamic examination that offers valuable information about functioning of the fallopian tubes. The first advantage of HyCoSy is that the client doesn’t have to undergo any hospitalization, as with x-ray hysterosalpingography or laparoscopy. A client during HyCoSy is not exposed to x-ray ionizing radiation in the area of the pelvis minor and especially the ovaries as with x-ray hysterosalpingography, where the possibility also exists of development of acute allergic reaction to x-ray contrast medium. HyCoSy versus laparoscopy does not require any form of anaesthetic and at the same time with laparoscopy a single-day or longer term hospitalization is required. Laparoscopy as well as other operations bear in themselves the risk of a surgical intervention and anaesthesia itself. Sometimes, however, the same important diagnostic cannot be avoided.
A lot of women experience unusual bleeding especially during menopause. This is often a consequence of hormonal changes, where an operation (excochleation, hysteroscopy) has a very few benefits. Therefore, if HSN does not display an evident problem in the uterine cavity, further examination (excochleation, hysteroscopy, etc.) is not necessary. Sometimes with standard gynecological ultrasound the uterine mucosa appears normal, but during HSN we see polyps or another organic change. The most common findings are polyps of the endometrium, myoma, endometrial hyperplasia and adenomyosis. HSN with causes of infertility and repeating miscarriages can diagnose growths, polyps of the mucosa or lining defects of the uterus, which can prevent pregnancy occurring. It evaluates in detail the uterine mucosa in patients with tamoxifen treatment for breast cancer. HSN is an essential examination for the evaluation of the quality of the uterine “scar” after two or more Caesarean sections in clients planning further reproduction.
