Sonohysterogram

Sonohysterography, also known as saline infusion sonography, is a special minimally invasive ultrasound technique. It provides pictures of the inside of a woman's uterus.

What Are Some Common Uses of the Procedure?
This is a valuable technique for evaluating unexplained vaginal bleeding that may be the result of uterine abnormalities, such as:

  • Polyps
  • Fibroids
  • Endometrial atrophy
  • Endometrial adhesions (or scarring)
  • Malignant lesions/masses
  • Congenital defects

Sonohysterography is also used to investigate uterine abnormalities in women who experience infertility or multiple miscarriages.

Doppler ultrasound images can help the physician to see and evaluate:

  • Blockages to blood flow, such as clots
  • Blood flow in polyps, tumors and congenital malformations
  • Pelvic varicose veins and aneurysms

How Should I Prepare?
No special preparation is required prior to the exam. You may be advised to take an over-the-counter pain medication shortly before the procedure to minimize any potential pain. Here are a few reminders for the day of your procedure:

  • Wear comfortable, loose-fitting clothing.
  • Remove all clothing and jewelry.
  • You may be asked to wear a gown during the procedure.

It is best to perform sonohysterography one week after menstruation to avoid the risk of infection. At this time in the menstrual cycle, the endometrium is at its thinnest, which is the best time to determine if the endometrium is normal. The timing of the exam may vary, however, depending on your symptoms and their suspected origins. Sonohysterography should not be performed if you are pregnant.

How Is the Procedure Performed?
A baseline transvaginal ultrasound procedure is usually performed first to view the endometrium, including its thickness and any associated ovarian abnormalities.

A transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer into the vagina after you empty your bladder. The tip of the transducer is smaller than the standard speculum used when performing a Pap smear.

A condom is placed over the transducer, lubricated with a small amount of gel and then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina. The images are obtained from different orientations to get the best views of the uterus and ovaries.

Sonohysterography is then performed as a more in-depth investigation of the abnormalities and their potential causes. Determining the locations of certain abnormalities, such as fibroids or polyps, can be important when establishing a treatment or management strategy for a patient's particular condition.

Following the baseline exam, the transvaginal probe will be removed and a sterile speculum will be inserted as you lie on your back with your knees bent and your feet in stirrups. The cervix will be cleansed, and a catheter will be inserted into the uterine cavity. Once the catheter is in place, the speculum will be removed and the transvaginal probe will be re-inserted into the vaginal canal. Sterile saline will then be injected through the catheter into the uterine cavity as the ultrasound is performed.

What Will I Experience During and After the Procedure?
Most ultrasound examinations are painless, fast and easy. Although the examination is often performed to look for a cause of pelvic pain, the sonogram itself should not be painful or significantly increase your discomfort.

A vaginal sonogram is usually more comfortable than a manual gynecologic examination.

During the sonohysterogram, you may feel occasional cramping as a result of the introduction of the saline. Over-the-counter pain medication should be sufficient to minimize any discomfort associated with the procedure. It is normal to have vaginal spotting for a few days after the procedure. After an ultrasound exam, you should be able to resume your normal activities immediately.

What Are the Benefits and Risks of Sonohysterography?
Benefits

  • It is noninvasive (no needles or injections) and usually painless.
  • It is widely available, easy to use and less expensive than other imaging methods.
  • It does not use any ionizing radiation.
  • It’s a simple procedure with few complications.
  • It’s a relatively short procedure that provides an excellent view of the uterus and endometrial lining.
  • Many uterine abnormalities that may not be seen adequately with routine transvaginal ultrasound may be viewed in detail with sonohysterography.
  • It can prevent unnecessary surgery and ensure that all polyps and fibroids are removed at surgery.

Risks

  • For standard diagnostic ultrasounds, there are no known harmful effects.

Who Interprets the Results and How Do I Get Them?
Our board-certified radiologists will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

Gwinnett Medical Center Imaging has multiple convenient Atlanta-area locations in Lawrenceville, Hamilton Mill and Duluth. If you would like to schedule an appointment, please call 678-312-3444.