Sonohysterogram

What is a sonohysterography?

A sonohysterography is a special kind of ultrasound exam. Fluid is put into the uterus through the cervix using a thin plastic tube. Sound waves are then used to create images of the lining of the uterus. The fluid helps show more detail than when ultrasound is used alone. This test can be done in your obstetrician-gynecologist’s (ob-gyn) office, a hospital, or a clinic. It usually takes less than 30 minutes.

For what reasons is a sonohysterography performed?

A sonohysterography can find the underlying cause of many problems, including abnormal uterine bleeding, infertility, and repeated miscarriage. It is able to detect the following:

  • Abnormal growths inside the uterus, such as fibroids or polyps, and information about their size and depth
  • Scar tissue inside the uterus
  • Abnormal uterine shape
  • Problems with the lining of the uterus
  • Whether the fallopian tubes are open or blocked

What is done to prepare for a sonohysterography?

A sonohysterography is not done if you are or could be pregnant or if you have a pelvic infection. You may be given a urine test to rule out pregnancy before the procedure. You will be asked if you are allergic to latex.

The test usually is scheduled at a time in your menstrual cycle after your period has stopped but before ovulation. If you are bleeding at the time of the test, the results may not be as clear. If you have off-and-on abnormal bleeding or bleeding that will not go away, you may be given medication to stop the bleeding before the test.

A sonohysterography is done when your bladder is empty. You will be asked to undress from the waist down and lie on an exam table. Your ob-gyn may do a pelvic exam to see if you have any tenderness or pain. If your ob-gyn thinks you have an infection, you may need to take antibiotics to clear up the infection before you have the procedure.

The procedure can cause some cramping. You may want to take an over-the-counter pain reliever, such as ibuprofen or acetaminophen, beforehand. Ask your ob-gyn what he or she recommends.

What are the main steps of a sonohysterography?

A sonohysterography has three main steps:

1) performing an initial transvaginal ultrasound exam, 2) putting fluid inside the uterus, and 3) repeating an ultrasound exam.

What is a transvaginal ultrasound exam?

For a transvaginal ultrasound exam, an ultrasound transducer—a slender, handheld device—is placed in the vagina. It is covered by a disposable sheath (like a condom). It sends out sound waves that are used to make images of the internal organs. These images are shown on a screen.

How is the fluid put inside the uterus for a sonohysterography?

After the first transvaginal ultrasound exam, the transducer is removed. A speculum is placed in the vagina. It holds the vagina open. A swab is passed through the speculum to clean the cervix.

Next, a thin tube is inserted into the vagina and placed in the opening of the cervix or inside the uterus. The speculum then is removed.

The transducer is placed in the vagina again. Sterile fluid is slowly passed through the tube. Cramping may occur as the fluid goes into the uterus.

What happens after the fluid is put inside the uterus for a sonohysterography?

When the uterus is filled with fluid, ultrasound images are made of the inside of the uterus and the uterine lining. If the test is being done to assess your fallopian tubes, fluid containing bubbles is placed inside the uterus through the tube. The bubbles make the fluid easier to see. The pathway of the fluid through the fallopian tubes is noted on ultrasound.

What can I expect after a sonohysterography?

Most women are able to go home right away and are back to their normal activities that day. Some of the following symptoms may occur after the test:

  • Cramping
  • Spotting or light bleeding
  • Watery discharge

What are the risks of a sonohysterography?

This test is very safe, but there is a rare risk of pelvic infection. Call your ob-gyn if you have any of the following symptoms:

  • Pain or fever in the day or two after you go home
  • A change in the type or amount of discharge