A one-stop Menstrual Disorder clinic with access to immediate access to transvaginal USS provides rapid access, one-stop assessment for the investigation and treatment of women with menstrual problems and postmenopausal bleeding. If the USS findings are abnormal, Sonohysterography (SH) is performed. This is a new outpatient technique of imaging the uterine cavity without recourse to hysteroscopy. In essence it involves the introduction of a very fine catheter through the cervix and visualisation of the uterine cavity through ultrasound imaging after the injection of 10 to 15mls of saline.
The diagnostic efficacy of SH has been evaluated in over 4000 women in more than 40 studies. It compares very well with diagnostic hysteroscopy with reported sensitivities and specificities over 90% in correctly identifying or excluding intrauterine pathology
The advantages of this technique are • It does NOT require any anesthesia • It bypasses the need for a diagnostic hysteroscopy in over two thirds of women who would normally require this investigation when transvaginal USS is abnormal. • Majority of women will have a diagnosis of the problem in one visit. • Six out seven women will have treatment instituted at the same visit.