Gel Sonovaginography

Abstract

Gel sonovaginography is a new way of assessing local cervical and vaginal disorders, in which regular transvaginal sonography is known to have limitations. In gel sonovaginography, 20 mL of ultrasound gel is instilled into the vagina, followed by examination with a transvaginal transducer. In a study involving 28 women with known or suspected disorders such as cervical and vaginal cancer, cervical polyps, vaginal septa, and deep infiltrating endometriosis, a substantial improvement in visualization and assessment of local lesions and structures was noted with gel sonovaginography. This simple technique appears to be valuable for accurate diagnosis of local cervical and vaginal disorders.

Patient experience when self‐introducing gel into the vagina for assessment of deep endometriosis: A pilot study

“…and pelvic compartments. 2,8,10 Although this method enhances the diagnosis of DE, it is invasive and may be painful for the patient.…”

“…18,19 Detection of DE in the posterior compartment has a low sensitivity, thus several studies have improved the TVUS method by using an acoustic standoff, either saline or gel, to increase the distance and enhance the acoustic window between the transvaginal probe and the surrounding structures of the vagina. 5,10 Any measures that may improve the patient experience when undergoing SVG examination may lead to improvements in care, and possibly, results.…”

“…Terumo ® brand luer slip tip syringes (Terumo Australia Pty Limited, Terumo Corporation Japan) were used as per the method published by Sibal in 2016 which included the use of 20 mL of gel. 10 Prior to consent, participants were also provided a sample of the different syringes to assess the size. The SVG examination was explained with the amended procedure and the opportunity to ask questions or obtain further clarification was offered and subsequently provided if needed.…”

“…4 A total of 20 mL of gel was introduced into a plastic syringe prior to performing the TVUS, with care taken not to include excessive air bubbles. 10 The plastic syringe with gel is then inserted into the posterior fornix of the vagina by the sonographer. 8,10 As the sonographer must manually guide the syringe into the patient's vagina, this technique is invasive and a 20 mL syringe may be uncomfortable and painful for the participant.…”

“…10 The plastic syringe with gel is then inserted into the posterior fornix of the vagina by the sonographer. 8,10 As the sonographer must manually guide the syringe into the patient's vagina, this technique is invasive and a 20 mL syringe may be uncomfortable and painful for the participant. It is our practice to allow gel insertion by the participants, inserting the gel syringes themselves rather than the sonographer, improving participant autonomy, control and potentially comfort.…”