Summary
In a prospective, randomized study, 10 patients with primary sterility received an
intracervical application of 0.1 mg Sulprostone-Tylose gel for cervical priming 12 hours
prior to panoramic CO2-hysteroscopy and pelviscopy with chromopertubation. Ten patients who served as controls
were not treated with the local prostaglandin. The force required to overcome the
cervical canal was measured with a special tonometer for Hegar 3 before application
of the gel in the group treated with Sulprostone and was 3-8 mm in both groups of
patients immediately preoperatively.
Cervical priming led to a significant reduction in the force required to dilate the
cervix. After priming with Sulprostone, the cervical canal was freely passable for
an average of 6.7 mm. In none of these patients was a force of 7 Newton exceeded for
Hegar 8, whereas in the control group a mean force of 8.2 Newton was required to dilate
the cervix for Hegar 6. Haemorrhage and epithelial lesions of the cervix caused by
the dilatation can largely be avoided, and the risk of uterine damage reduced by local
priming of the cervix. The intracervical application of prostaglandin gel is an easy,
efficient and gentle method of dilatation for hysteroscopy, particularly in patients
with a firmly closed and rigid cervix.
Key words:
Panoramic CO2-hysteroscopy - Cervical dilatation - Reduction of cervical resistance by locally
applied Sulprostone gel
