Sonohysterogram

Overview

A sonohysterogram, also known as saline infusion sonography (SIS), is a specialized ultrasound procedure used to evaluate the uterus. By injecting sterile saline into the uterine cavity, this test provides enhanced images of the uterine lining and helps identify abnormalities. It is particularly useful in diagnosing conditions affecting fertility, menstrual irregularities, or unexplained pelvic pain.

What Is a Sonohysterogram?

A sonohysterogram combines ultrasound technology with a saline solution to provide detailed imaging of the uterus. The procedure helps visualize the uterine cavity more clearly than a standard pelvic ultrasound by distending the uterine walls with saline. This allows healthcare providers to detect structural abnormalities, such as polyps, fibroids, or scar tissue, and assess the thickness and integrity of the endometrium.

Why Is a Sonohysterogram Conducted?

A sonohysterogram is typically recommended to:

• Investigate abnormal uterine bleeding.
• Diagnose uterine polyps, fibroids, or scar tissue (adhesions).
• Evaluate unexplained infertility or recurrent miscarriages.
• Assess the uterine cavity before fertility treatments, such as in-vitro fertilization (IVF).
• Monitor the success of surgical interventions, such as polyp or fibroid removal.

Preparation for the Sonohysterogram

• Timing: The procedure is usually scheduled just after your menstrual period but before ovulation (days 6-12 of your cycle) to minimize the risk of infection and ensure accurate imaging.
• Medications: You may be advised to take an over-the-counter pain reliever, such as ibuprofen, about an hour before the procedure to reduce discomfort.
• Hydration: Drinking water may be recommended to fill your bladder slightly, depending on the ultrasound type.
• Infection Screening: Your doctor may check for infections beforehand to prevent complications.

Procedure

• Preparation: You will lie on an examination table in a position similar to a gynecological exam. A speculum is inserted into the vagina to access the cervix.
• Catheter Insertion: A thin, flexible catheter is inserted through the cervix into the uterine cavity. This step may cause mild cramping.
• Saline Injection: Sterile saline is gently introduced through the catheter into the uterus, expanding the uterine cavity for better visualization.
• Ultrasound Imaging: A transvaginal ultrasound probe is used to capture detailed images of the uterine lining and surrounding structures.
• Duration: The procedure typically takes 15-30 minutes.
• Comfort: Sonohysterogram is painless, though slight pressure from the transducer may be felt.

Interpretation of Results

Normal Findings: A uniformly smooth uterine lining with no abnormalities or obstructions in the uterine cavity.

Abnormal Findings: These could include:

• Polyps or fibroids within the uterine cavity.
• Uterine septum or structural deformities.
• Scar tissue (Asherman’s syndrome).
• Fluid or other indicators of infection or inflammation.

Your doctor will review the results and discuss next steps, which may include additional tests or treatment.

Benefits of the Sonohysterogram

• Provides a clear and detailed view of the uterine cavity.
• Enhances diagnostic accuracy compared to standard ultrasounds.
• Aids in planning and optimizing fertility treatments.
• Minimally invasive with a quick recovery time.

Risks and Limitations

• Risks: While generally safe, there is a small risk of infection, spotting, or cramping following the procedure.
• Limitations: The test may not detect abnormalities in the fallopian tubes or ovaries. Other imaging techniques, such as hysterosalpingography (HSG) or MRI, may be recommended for comprehensive evaluation.

Frequently Asked Questions (FAQs)

1. Is a sonohysterogram painful?

   Most people experience mild to moderate cramping during the procedure, particularly when the saline is injected. Taking a pain reliever beforehand can help reduce discomfort. The procedure is generally well-tolerated and quick.

2. How is a sonohysterogram different from a standard ultrasound?

   A standard ultrasound provides images of the uterus and surrounding organs but may not clearly show the uterine cavity. The sonohysterogram’s use of saline expands the uterine walls, offering a more detailed view of the uterine lining and cavity.

3. Can a sonohysterogram detect fallopian tube issues?

   No, the sonohysterogram is specifically designed to evaluate the uterine cavity. For fallopian tube assessment, a hysterosalpingography (HSG) or specialized ultrasound with contrast (saline infusion sonohysterography with bubbles) is typically used.

4. Are there any restrictions after the procedure?

   You can resume normal activities immediately after the procedure. However, you may experience light spotting or mild cramping for a day or two. Using sanitary pads instead of tampons is often recommended to reduce infection risk.

5. What conditions can a sonohysterogram diagnose?

   The procedure is effective in diagnosing uterine polyps, fibroids, scar tissue, uterine septum, and other abnormalities that could impact fertility or cause abnormal bleeding. It also helps assess the thickness and condition of the endometrium.

6. How soon are the results available?

   The results are typically available within a few days. Your doctor will review the findings and discuss any necessary follow-up care or treatments.

7. Can a sonohysterogram be performed during pregnancy?

   No, the procedure is contraindicated during pregnancy. It is essential to rule out pregnancy before scheduling a sonohysterogram.

8. Is a sonohysterogram safe for everyone?

   The procedure is safe for most individuals but may not be recommended for those with active pelvic infections or certain cervical or uterine conditions. Your doctor will evaluate your medical history to determine suitability.

9. What should I do if I feel unwell after the procedure?

   While mild cramping and spotting are normal, contact your doctor if you experience severe pain, heavy bleeding, fever, or unusual discharge, as these may indicate infection or complications.

10. How should I prepare for a sonohysterogram?

    Preparation involves scheduling the test for the right time in your menstrual cycle, taking a pain reliever if advised, and following any specific instructions from your doctor. Avoiding sexual intercourse or tampon use before the procedure may also be recommended.

Conclusion

A sonohysterogram is a valuable diagnostic tool that offers detailed insights into uterine health. Its ability to detect abnormalities in the uterine cavity makes it an essential procedure for diagnosing fertility issues and addressing menstrual irregularities. If your doctor recommends a sonohysterogram, it is a safe and effective step toward understanding and managing your reproductive health.