Gynaecology units

3D transvaginal ultrasound

For several years now, 3D transvaginal ultrasound has been considered more effective than conventional ultrasound for gynaecological diagnosis. It allows more accurate identification and classification of uterine abnormalities such as septate uterus, bicornuate uterus or unicornuate uterus, as well as precise assessment of the presence, shape and size of fibroids within the endometrium—factors that can be decisive in achieving pregnancy and carrying it to term.

In addition, 3D transvaginal ultrasound is a fast and easy procedure to perform and is less uncomfortable than hysteroscopy, the test traditionally used to visualise the interior of the uterine cavity. Hysteroscopy involves the introduction of a hysteroscope that transmits images to a video monitor and may require the instillation of gas or fluid into the uterus to allow adequate visualisation of the entire cavity.

Furthermore, transvaginal ultrasound does not require the patient to have a full bladder, a discomforting requirement that often delays conventional 2D ultrasound examinations. A medical report can also be prepared during the same visit, further streamlining the diagnostic process.

For all these reasons, 3D transvaginal ultrasound has become the technique of choice for the assessment of uterine malformations. It is a completely painless and rapid procedure that allows immediate reporting during the same appointment.

HyFoSy-3D

Hysterosalpingo-foam sonography (3D HyFoSy) represents one of the most significant advances in gynaecological diagnostics in recent years. Its effectiveness, safety and—above all—its painless nature have led national and international scientific societies to recommend it over conventional techniques. The Grupo Pedro Jaén Gynaecology Unit is one of the few private centres in Madrid where this technique is available to patients.

What does 3D HyFoSy involve?

Contrast-enhanced sonohysterosalpingography is an imaging test used to obtain a precise representation of the morphology of the uterine cavity and the Fallopian tubes. 3D HyFoSy essentially consists of introducing a small cannula through the cervix, through which a stabilised foam is instilled to fill both the uterine cavity and the Fallopian tubes. This foam remains stable for approximately five minutes and is then naturally reabsorbed.

One of its major advantages is that it does not require iodinated contrast agents, which may cause allergic reactions. The foam used at Grupo Pedro Jaén is made from a combination of cellulose gel and glycerol mixed with air bubbles and purified water, and does not cause allergic or adverse reactions.

By contrast, conventional hysterosalpingography uses ionising radiation—an important consideration when imaging the pelvis of women who are trying to conceive and planning a future pregnancy.

Indications for 3D HyFoSy

• Tubal patency: Assessment of Fallopian tube patency is essential in assisted reproduction processes when investigating possible causes of female infertility. Contrast-enhanced sonohysterosalpingography is recommended in patients undergoing assisted reproduction whose male partners have a semen analysis indicating sperm suitable for insemination.
  If the semen analysis shows significant sperm abnormalities, tubal status is less relevant, as patients are usually referred directly for in vitro fertilisation (IVF).
• Uterine malformations. Uterine malformations: Because this technique provides highly accurate assessment of the uterine cavity, gynaecologists with access to 3D transvaginal ultrasound—such as those at the Grupo Pedro Jaén Gynaecology Unit—can also use it to detect and evaluate morphological anomalies such as a unicornuate uterus or a uterine septum.

In this context, 3D HyFoSy provides a much more precise image of the uterine cavity and its structures than conventional hysterosalpingography. Its diagnostic accuracy is comparable to that of magnetic resonance imaging (MRI), but often at a lower cost.

Fibroids

Fibroids are among the most common gynaecological conditions in women of reproductive age. They may be associated with menstrual disorders as well as infertility or pelvic pain. Surgical management of fibroids can be performed using different techniques and approaches depending on each case, most commonly through mini-laparotomy or laparoscopic removal.

Endometriosis

Endometriosis is a highly prevalent condition in young women. It is characterised by cyclical or continuous pelvic pain and represents one of the main causes of infertility. Early diagnosis and appropriate therapeutic guidance are essential to minimise long-term consequences for fertility and quality of life.

Initial management is usually conservative, combining hormonal treatment with techniques aimed at preserving ovarian reserve. In more severe cases or when response to conservative treatment is insufficient, laparoscopic surgery is indicated.

Ovarian cysts

Ovarian cysts encompass a wide spectrum of gynaecological pathology. Currently, laparoscopic surgery is the most common approach for their removal. In women of reproductive age, careful surgical management is essential to avoid compromising future fertility, while in older patients treatment is focused on excluding malignancy.

Breast disease

Breast conditions are among the most prevalent health issues affecting women. Whether benign disease or breast cancer, surgical treatment must be carried out with the utmost precision and attention to aesthetic outcomes. For this reason, the Grupo Pedro Jaén Gynaecology Unit offers the possibility of combined management involving gynaecologists and plastic surgeons, applying the most advanced autologous breast reconstruction techniques (breast reconstruction using the patient’s own tissue) in the treatment of breast cancer.

Vaginal laxity

Vaginal laxity is characterised by loss of firmness of vaginal tissues, weakening of the supporting musculature and widening of the vaginal canal. Although often associated with ageing, it can also affect younger women.

It may be related to overweight or obesity, previous obstetric factors such as recent childbirth, large babies, instrumental delivery with forceps, spatulas or vacuum extraction, as well as high-impact sports practised at an intense level, such as running, where repetitive impact combined with gravity increases the risk.

Finally, women who practise certain sports at a very high intensity, such as running, may have an increased risk of developing vaginal laxity due to repetitive impact combined with the effects of gravity.

Urinary incontinence

Urinary incontinence is commonly associated with pelvic tissue laxity and loss of bladder support, particularly after childbirth, during menopause or following urogenital surgery. Depending on severity and individual circumstances, radiofrequency or vaginal laser treatments may have a very positive effect on stress urinary incontinence by inducing controlled heat and stimulating new collagen formation, restoring tissue tone and support.

Vaginal atrophy

Menopause is marked by a decline in oestrogen production. This hormonal reduction not only leads to cessation of menstruation, but also affects multiple aspects of physical and emotional health, as hormones are involved in nearly all bodily functions.

One consequence of reduced oestrogen levels is decreased collagen production. Collagen is an essential structural protein that provides firmness and consistency to tissues and is responsible for skin hydration and tone. Its decline results in drier, thinner and more fragile tissues.

Loss of collagen is directly related to genitourinary syndrome, a condition frequently encountered by gynaecologists, particularly during menopause but also at other stages of life, such as the postpartum period.

Despite persistent taboos surrounding these concerns, consultation for vaginal atrophy has become increasingly common. Although it does not pose a life-threatening risk, it can significantly impair quality of life, mood, self-esteem and intimate relationships. Women are increasingly seeking treatment to ensure that menopause remains a fulfilling and healthy life stage.

Anorgasmia

Anorgasmia, or difficulty achieving orgasm, affects approximately 20% of women. This condition negatively impacts sexual and emotional health, self-esteem and couple relationships. It is relatively common after childbirth or during menopause and is usually the result of a combination of emotional, hormonal and physical factors.

Based on our specialists’ experience, addressing the underlying physical and functional causes of anorgasmia often leads to significant improvement in emotional wellbeing and psychological symptoms.

Genitourinary syndrome

This condition, associated with oestrogen decline and collagen deficiency, affects the labia majora and minora, vaginal introitus, vulvar vestibule, clitoris, vagina, urethra and bladder. It is characterised by loss of elasticity and trophism—referring to thickness and texture of the vaginal mucosa.

This leads primarily to vaginal dryness, reduced lubrication and tissue laxity, causing itching, burning and discomfort that can significantly interfere with daily life during menopause. Many women describe symptoms similar to cystitis, although in reality this is often atrophic trigonitis, an inflammatory condition not caused by infection.

Loss of trophism also impairs natural lubrication, making sexual intercourse uncomfortable or painful, and increases the recurrence of urogenital infections, as vaginal trophism and microbiota form a protective barrier against pathogens.

There are different options for vaginal rejuvenation, including cosmetic, hormonal and physical treatments (such as mesotherapy, bipolar radiofrequency and CO₂ laser). These therapies are indicated for different vaginal conditions and functional concerns.

More information on the Grupo Pedro Jaén Vaginal Rejuvenation page.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to accuracy, scientific rigour and up-to-date medical information.