Patient Information - Sonohysterography Exam

What Is Ultrasound?
Ultrasound is like ordinary sound except it has a frequency (pitch) higher than human beings can hear. When sent into your body through a transducer (either resting on your skin or inserted into a body cavity, such as the vagina), the sound is reflected off internal structures. The returning sounds (echoes) are received by the transducer and converted by a specialized computer into an image of the internal structures that can be viewed on a monitor similar to a television screen. Ultrasound images can be recorded on recording media such as CD-ROM, videotape, film, or paper. Diagnostic ultrasound imaging is commonly called sonography or ultrasonography.

Is Ultrasound Safe?
There are no known harmful effects associated with the medical use of sonography. Widespread clinical use of diagnostic ultrasound for many years has not been shown to cause any harm. Studies in humans have revealed no direct link between the use of diagnostic ultrasound and any adverse outcomes. Although the possibility exists that biological effects may be identified in the future, current information indicates that the benefits to patients far outweigh the risks.

What Is Sonohysterography, Or Saline Infusion Sonohysterography (SIS)?
Sonohysterography consists of sonographic imaging of the uterus and cervix while injecting sterile saline (fluid) into the uterine cavity.

Why Should I Have A Sonohysterogram?
Sonohysterography is used to evaluate abnormalities of the endometrium (inside lining of the uterus) in women with abnormal vaginal bleeding, in women whose endometrium appears abnormal on pelvic ultrasound, or for evaluation of infertility. Sonohysterography is less invasive than hysteroscopy, dilation and curettage (D&C), or endometrial biopsy and may detect problems such as polyps, fibroids, or adhesions inside the uterus.

What Does The Procedure Involve?
An initial vaginal ultrasound examination is performed. The ultrasound transducer is then removed, and a speculum is inserted into the vagina to help see the cervix. A small catheter will be inserted into the cervix, and sterile saline (fluid) will be injected while a vaginal ultrasound examination is again performed.

Will It Hurt?
Pelvic cramping similar to menstrual cramping can occur during the saline infusion. This usually stops once the infusion stops and the catheter is removed.

What Are The Limitations Of The Examination?
Sonohysterography can be difficult to perform in women with

Large fibroids or adhesions, which can obstruct the saline infusion; or
Cervical stenosis (tightening of the cervix), which can complicate the catheter insertion.

Is Specific Preparation Required?
Preparations for the procedure are similar to those for a routine pelvic examination or a vaginal ultrasound examination. You will be asked to empty your bladder before the examination and to disrobe from the waist down. You will need to assume a position similar to the one used for a Pap smear with your legs in stirrups. Let the doctor or sonographer know if you have any latex allergies, any gynecological infections, or if there is any possibility of being pregnant. If you take preventive antibiotics before invasive procedures, you will need to take them.

How Will I Feel After The Examination?
Some vaginal spotting can occur. Cramping may occur and can be treated with acetaminophen (Tylenol) or ibuprofen (Motrin). You should call your doctor if there is any abnormal bleeding, pain, or fever.

What Are The Risks Of This Examination?
There is a small risk of infection from the procedure. If you develop a fever or any other symptoms of infection, you should call your doctor so that your doctor can administer antibiotics. If an infection occurs, it is usually minor and can be treated easily if reported right away. Overall, the procedure is safe and well tolerated.

Last updated September 2005