Hysterosonography is an ultrasound of the uterus, and is also known as saline infusion sonography. An ultrasound of the uterus has many advantages over other imaging techniques, such as x-rays. It uses sound waves so there is no risk of ionizing radiation, and it provides a clear view of soft tissues in real time. The injection of sterile saline enlarges the uterus, outlining the endometrium (the lining of the uterine cavity). Thus, this procedure allows a thorough examination of the endometrium and ovaries.

Hystersonograms can help to diagnose:

• Unexplained vaginal bleeding
• Polyps
• Fibroids
• Endometrial atrophy
• Congenital defects
• Malignant or benign masses
• Endometrial adhesions or scarring
• Any abnormalities in women who experience infertility or miscarriages

What to expect

Your bladder must be emptied before the procedure. A baseline ultrasound maybe performed prior to the injection of saline. You will lie on your back with your feet in stirrups. A sterile speculum will be inserted and the cervix will be cleansed. A catheter will be inserted into the uterine cavity, and the speculum removed. The transvaginal probe is then inserted into the vaginal canal. The probe is a small transducer, and is lubricated with a small amount of gel before it is inserted. As the ultrasound is being done, a sterile saline is injected through the catheter into the uterine cavity. Sometimes air can be passed through to study the fallopian tubes.

The hysterosonography is usually performed one week after menstruation, when the endometrium is the thinnest, making it easier to examine for abnormalities and reducing the chances of infection. However the timing may depend on the symptoms and suspected illness. You may experience some cramping during the exam because of the sterile saline injection. This can be avoided by taking over-the-counter pain medication 1-2 hours prior to the exam. You may experience some discomfort during the procedure, but it is painless and well tolerated by most patients. It takes approximately an hour for the whole visit. Please let us know if there is a possibility that you are pregnant.

Some light spotting after the procedure is common, but if you are experiencing abnormal bleeding, fever, or pain, contact us or the nearest emergency department.