Probing of the uterus cavity

Probing the uterine cavity is an operation to determine the direction of the uterine cavity, its length and the state of the relief of the walls. Probing of the uterus is made by a uterine probe made of soft metal, 25 cm in length, 3 mm in diameter. At the end of the probe there is a button and a thickening at a distance of 7 cm from the button, corresponding to the normal length of the uterine cavity; centimeter separations are marked on the surface of the probe.

Probing of the uterine cavity is performed as a diagnostic procedure before artificial abortion, and also for the purpose of determining the length of the uterine cavity before the diagnostic curettage. In order to detect submucous myomatous nodes, sounding is of relative value.

The cervix is exposed by mirrors. Her front lip is taken with bullet pincers and reduced. A probe is inserted through the cervical canal. Advance it carefully, so as not to make a false move or not perforate the wall of the uterus.

[1], [2], [3], [4], [5]

Indications for the procedure

The sounding is performed before the diagnostic curettage of the uterine cavity, with abortion, to determine the anomalies of the development of the uterus, the submucous node in the uterus.

[6], [7], [8]

Preparation

Probing of the uterus is made only in a hospital with the observance of rules of asepsis and antiseptics.

[9], [10], [11], [12]

Technique of the probing the uterus

First of all, the uterine probe is bent according to the position of the uterus, determined with a two-hand vaginal examination. After disinfection of the external genitalia, the cervix is exposed by mirrors, the vagina and the vaginal part of the cervix are wiped with alcohol. With bullet forceps grab the front lip of the cervix, then remove the lift, and pass the mirror to the assistant. Left hand operating with bullet forceps reduces and fixes the cervix, and the right hand takes the probe so that its handle freely lies between the thumb and forefinger. Introduce the probe into the cervical canal and without the use of force gently push it into the cavity to the bottom of the uterus. After the probing, the probe is removed, bullet forceps are removed and the vaginal part of the cervix is smeared with iodine.

On the scale of the uterine probe determine the length of the uterine cavity. An increase or decrease in its length indicates a pathology ( adenomyosis, uterine myoma, uterine hypoplasia, etc.). A different length in the area of the corners of the uterus indicates its asymmetry. The direction of movement of the probe is determined by the position of the uterus: in the anteflexio position the probe is directed anteriorly, in the retroflexio position - posteriorly. The relief of the walls of the uterine cavity is smooth and smooth. A dense uneven surface, prominent in the uterine cavity, indicates the presence of submucous myoma. Areas of soft consistency are suspect for malignant process. In case of anomalies in the development of the uterus, a septum in the uterus or a double uterus is determined. Bloody discharge during or after sensing may appear due to light tissue injury, polyposis, endometritis or uterine cancer.

Contraindications to the procedure

Contraindications for sounding of the uterus are: acute and subacute inflammatory processes of the genital organs, III-IV degree of purity of the vagina, suspicion of uterine pregnancy.

[13], [14], [15], [16], [17], [18]

Complications after the procedure

When probing the uterus, it is possible to form a false path or  perforate its wall. This can happen if a vaginal examination is not performed before the probe and the position of the uterus is not determined, and also if the probe is inserted with force.

[19], [20], [21], [22], [23]