From Big Medical Encyclopedia

UTERINE PROBING (fr. sonder to find out, investigate) — the method of a gynecologic research which is carried out by means of the special uterine probe.

Indications: suspicion of submucosal myoma, malformations of a uterus, genital infantility; 3. to m it is shown at differentiation of a tumor of a uterus and ovary, before a scraping of walls of a uterus, at the infertility caused by an atresia of the channel of a neck of uterus (see. Gynatresia ).

3. m. contraindicated at suspicion on a uterine and extrauterine pregnancy (except cases of artificial abortion), at inflammatory processes of generative organs, suspicion of cancer of a neck of uterus and a vagina; at the III—IV degree of purity of a vagina.

Diagrammatic representation of uterine probing: the back wall of a vagina is delayed by means of a mirror, the front lip of a neck of uterus is taken by bullet nippers, the probe is entered into the cervical canal.

Uterine probing is made in the conditions of a hospital under control of sight at observance of rules of an asepsis and antiseptics. Before sounding it is necessary to make catheterization of a bladder and to empty intestines. For the prevention of a spasm of a neck of uterus in 20 — 30 min. prior to 3. it is reasonable to m to enter subcutaneously 1 ml of 0,1% of solution of sulfate of atropine. Position of the patient usual for ginekol, researches. After definition of position of a uterus in a small basin bare a neck of uterus by means of mirrors, process it alcohol and iodine. The front lip of a neck of uterus is taken and fixed the bullet nippers which are in the left hand of investigating. The probe (see. Obstetric and gynecologic tools , Probes ), withheld big and index by fingers of the right hand, enter into the cervical canal (fig). Usually it freely passes to an isthmus of a uterus. Difficulty during the carrying out the probe can be connected with formation of an acute angle between a body and a neck of uterus. A pandiculation for bullet nippers straighten this corner, the probe is given more curved situation and enter into a cavity of the uterus. Less often narrowing of the channel of a neck of uterus can be caused by cicatricial process; at the same time sounding demands extra care since rough manipulations can lead to creation of the false course and a perforation of a uterus. In case the ordinary probe does not pass through the narrowed channel of a neck of uterus and its spasm is excluded, use more stylet. After passing of a stylet it is necessary to replace it big on diameter. If the stylet did not possible to pass in a cavity of the uterus, it is necessary to refuse further attempts of sounding and to apply rentgenol, a research (see. Metrosalpingografiya ). In a cavity of the uterus the probe moves ahead easily up to an uterine fundus. Length of a cavity of the uterus (from an outside pharynx to the bottom) is determined by marks in the probe.

At 3. the m can gain an impression about the size and a form of a cavity of the uterus, its deformation, structural features of walls (density, smoothness, bleeding, a roughness, additional educations), to calculate a so-called uterine index (see. Infertility ). However results 3. m have the relative value since to a large extent are defined by individual tactile sensitivity of investigating.

Complications: perforation of a uterus, infection of generative organs, dissimination of malignant tumoral process. See also Gynecologic research , Uterus .

Bibliography: Mandelstam A. E. Semiotics and diagnosis of female diseases, L., 1976; The Multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 4, book 1, page 62, M., 1963; Persianinov L. S. Operational gynecology, page 166, M., 1976.

S. N. Kopshev.