What are the ExEm Foam Kit storage requirements?Simon Griffiths
- Store in suitable room and at a temperature between +5°C and +25°C.
- During transport of the ExEm Foam Kit, a temperature in the tolerance range between +5°C and +25°C must be maintained.
- However, the products may temporarily (no longer than one week) be exposed to temperatures up to +40°C.
- Typically 2 years' shelf life detailed on packaging, unopened.
How much does ExEm cost?Simon GriffithsPlease contact de Smit Medical for all pricing information.
How long do you have visualisation once the foam has been infused?Simon GriffithsOnce the required amount of the foam has been infused (2 – 3 ml) echogenicity should be maintained for approximately 7 minutes. If the test is prolonged, it may be necessary to infuse more of the Foam.
How long do the microbubbles stay as a foam?Simon GriffithsAt least 5 - 7 minutes (sealed syringe). The remaining solution may be remixed in the syringe to re-introduce the air bubbles.
What should I do in the event of tubal spasm?Simon GriffithsWait a few minutes for the spasm to stop and then continue scanning. It should not be necessary to infuse more foam unless echogenicity has been lot.
When should I perform the patency test?Simon Griffiths‘Tests of tubal patency are usually performed during the follicular phase of the cycle after menstruation has ceased’ The Fallopian Tube in Infertility and IVF Practice, chapter on Fallopian Tube Patency Testing – Stephen R. Killick: Cambridge Medicine
Ultrasound scanning of the uterusSimon Griffithsa) Which should I do first, the tubal patency test or the uterine scan? When conducting a combined diagnostic session, the intrauterine scan should always be conducted prior to the tubal patency test. The Uterine scan may highlight conditions that negate the need for the patency test – Hydrosalpinx. b) Can I use the ExEm Gel on its own (without mixing with purified water) to scan the Uterus? Yes. The ExEm Gel on its own is an excellent dilator and is will facilitate enhanced images due to its highly echogenic nature. Caution: due to the high viscosity of the ExEm Gel, a wait of at least 2 hours is recommended before then conducting a tubal patency test. c) How long should I wait between the uterine scan and the patency test? This will depend upon the contrast solution used for the uterine scan. No contrast – immediately. Saline – wait for a few minutes for the cavity to empty (remove the catheter). ExEm Gel – min 2 hours.
Are there any contraindications?Simon GriffithsExEm Foam Kit
- Do not use the gel foam in case of allergy to any of the constituents of ExEm gel (hydroxyethyl cellulose, glycerol and purified water)
- During pregnancy
- If the patient may be pregnant
- Between ovulation and menstruation
- If the patient has co-morbidities
- In the presence of active pelvic infection, sexually transmitted diseases and profuse bleeding