Sonohysterogram

What is a sonohysterogram?
This is a diagnostic screening study which combines transvaginal ultrasound with the infusion of a small amount of sterile saline solution into the uterus to visualize the endometrial cavity (inside of the uterus). The use of a fluid contrast enhances the ability of ultrasound to outline the anatomy of the uterus.

What are the indications for a sonohysterogram?
Sonohysterography may be used whenever we need to see the inside of the uterus. Postmenopausal or irregular vaginal bleeding, uterine fibroids or an enlarged uterus, infertility, recurrent miscarriage, and screening for IVF/Egg Donation IVF are all possible indications for this procedure.

How is a sonohysterogram done?
A standard transvaginal ultrasound exam is done first to check for the position of the uterus and to evaluate the ovaries. A small speculum is next inserted into the vagina and a tiny catheter is inserted into the cervix. A balloon at the tip of the catheter is inflated to occlude the cervical canal. A small amount of sterile saline solution is slowly infused into the uterine cavity under ultrasound visualization with the transvaginal transducer. Your physician can visualize the fluid inside your uterus on the ultrasound screen.

What kind of problems can be seen on a sonohysterogram?
The inside of the uterus should be smooth and regular. Irregular areas can signal uterine polyps, fibroids, adhesions (scar tissue), or abnormal growth of the lining (called the endometrium). Since sonohysterography is only a screening procedure, abnormal areas often require followup studies such as hysteroscopy, endometrial biopsy, or D&C.

Is a Sonohysterogram painful?
Ultrasound is a painless procedure which uses only sound waves to examine the uterus. Local anesthesia is generally not necessary for a sonohysterogram. You may experience some mild cramping as the catheter balloon is inflated or with the infusion of the saline solution. The majority of our patients tell us that this is a very easy and painless procedure.

Are there any potential complications of this exam?
Unfortunately, there are potential complications of all medical procedures. Fortunately, a sonohysterogram is considered a very safe procedure. Since diagnostic ultrasound uses only sound waves, no harmful effects are currently known. A rare complication of any procedure which involves infusion of fluid into the uterus (e.g. a hysterosalpingogram, IUI, etc.) is infection of the uterus, tubes, and ovaries.

What can I do after a sonohysterogram?
You can resume all normal activities (exercise, bathing, etc) immediately after your sonohysterogram. We recommend that you avoid sexual intercourse for 24 hours because the risk of infection is increased during this time period. A small amount of vaginal bleeding is not unusual for 1-3 days after the procedure. Occasionally, you may experience mild cramping for 6-24 hours, and Tylenol or Ibuprofen (Advil, etc.) are recommended if needed for these symptoms.