A significant number of women are referred to with bleeding problems related to the use of hormonal contraception, for advice on the management of heavy periods or following difficulty with intrauterine device insertion. The authors describe their experience with Instillagel® as the contrast medium for hysterosonography in a one-stop clinic for complex contraception referrals. They also comment on its analgesic properties for cervical and uterine instrumentation.
The authors reviewed 275 referrals seen over six months in consultant-delivered clinics provided by a contraception service. They describe the simple technique they use for hysterosonography with Instillagel.
Additionally, gel in the endometrial cavity, with a time interval between insertion of gel and uterine instrumentation, appears to result in analgesia and relaxation of the uterus. There was a very low incidence of difficulties in a group of patients who had previously experienced significant uterine instrumentation problems.
The study concluded that hysterosonography is a productive, simple, and inexpensive technique for assessing the endometrial cavity. It has many potential applications in contraceptive care. An additional benefit appeared to be that once gel was instilled in the hole, it facilitated the uterus’s instrumentation.
Reference: https://srh.bmj.com/content/38/2/110
