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What is Hysterosonogram?

Hysterosonogram, also known as sonohysterography, and saline infusion sonography, is a special, minimally invasive ultrasound technique. It provides pictures of the inside of a woman’s uterus. It is a valuable technique for an in depth evaluation of the endometrial lining of the uterus. It is most commonly used to evaluate for uterine abnormalities in women who experience unexplained vaginal bleeding and infertility. Many uterine abnormalities that may not be seen adequately with routine transvaginal ultrasound may be viewed in detail with sonohysterography.

What to Expect During the Procedure

This procedure is performed by a radiologist who is assisted by a sonographer, a technologist specially trained in ultrasound. The procedure is performed much like a gynecologic exam. You will lie on your back with your knees bent and your feet in stirrups. A sterile speculum will be inserted into the vagina, exactly like having a pap smear. A tiny catheter will be inserted into the uterine cavity. You may experience some pelvic pressure at this time. Once the catheter is in place, the speculum will be removed and the transvaginal probe, an ultrasound instrument similar in shape to a tampon, will be inserted into the vaginal canal by the sonographer. Sterile saline will then be injected through the catheter into the uterine cavity as the transvaginal ultrasound images are being taken. You may experience some pelvic cramping at this time. Most of the time, this only last a couple of minutes. The saline distends the uterine cavity, allowing the endometrial lining of the uterus to be evaluated. The more saline that is injected, the better the imaging will be.

How Should I Prepare?

You must have had a prior transvaginal ultrasound which serves as a baseline exam, within 3 months prior to your sonohysterography or hysterosonogram. If you did not have the transvaginal ultrasound exam done at our facility, please bring a copy of your exam with a report with you. If you have not had a prior transvaginal ultrasound and need one, please be aware that both of these exams cannot be performed on the same day due to insurance purposes. We will be happy to perform both exams for you but we cannot do both your baseline transvaginal ultrasound and your hysterosonogram at the same visit. It is best to perform a hysterosonogram when you are not bleeding if at all possible. Hysterosonograms should not be performed if you are pregnant! Please take all steps necessary to make sure that you are not pregnant as this exam could be harmful to a developing pregnancy.

What to Expect After the Procedure

Once the procedure is complete, any pelvic cramping you might have experienced during the exam should start to subside. You will be given a thick sanitary napkin to help with any vaginal discharge you may have after the procedure. You may also notice some light vaginal bleeding or spotting for a day or two following the procedure, which is normal. The radiologist performing your hysterosonogram will analyze the images taken during the procedure. A report will be dictated and sent to your physician within 5 business days, who will share the results with you.