Detect Abnormalities with Sonohysterography: Procedure & Risks

Detect Abnormalities

1. What is Sonohysterography?

Sonohysterography is a type of ultrasound exam.
Sterile fluid is put into the uterus through the cervix using a thin plastic catheter or tube.
The fluid helps show more detail than when ultrasound is used alone.
This test can be done in the clinic.
It usually takes less than 20 minutes.

2. For what reasons is a sonohysterography performed?

It can be useful to find the underlying cause of many problems, like infertility and repeated miscarriage. It is able to detect:

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

3. When to do & When not to do sonohysterography?

Sonohysterography is not done if you are or could be pregnant or if you have a pelvic infection.
The test usually is scheduled at a time in your menstrual cycle after your period has stopped.
If you are bleeding at the time of the test, the results may not be as clear.

4. How to do Sonohysterography ?

It is done when bladder is empty.
You will be asked to undress from the waist down and lie on an exam table.
If we think of any infection, patient may need to take antibiotics to clear up the infection before you have the procedure.

5. What are the main steps of a sonohysterography?

Sonohysterography has three main steps:

Performing an initial transvaginal ultrasound exam,
Putting fluid inside the uterus, and
Repeating an ultrasound exam.

6. 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. A sterile fluid is slowly passed through the tube. Cramping may occur as the fluid goes into the uterus.

7. 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.

8. 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

9. What are the risks of a sonohysterography?

This test is very safe, but there is a rare risk of pelvic infection.

Polyp in endometrium.

The typical sonographical appearance of an endometrial polyp is that of a well-circumscribed homogeneous lesion that is isoechoic to the endometrium yet preserves the endometrial-myometrial interface.
Endometrial polyps can present in diverse manifestations such as cervical polyps, polyps with feeding vessels, multiple polyps or polyps with cystic change.
A less common manifestation is a polyp with a broad base of attachment, a polyp which contains cystic components, or a polyp which contains areas of hypoechogenicity/heterogeneity within the polyp.

Uterine septum

A uterine septum is an upside-down, triangular shaped piece of tissue which divides all or part of the uterine cavity in two.
The tissue is a left over remnant from normal, embryonic uterine development and is most commonly discovered with an HSG (hysterosalpingogram).
The septum may frequently be overseen on routine ultrasound scans, particularly in cases when it is very small/short.
The saline appears dark black on the ultrasound.
Abnormal growths in the uterine cavity will appear as ovoid, grey to white growths that protrude into the cavity.
A cavity that is split will show the black appearing saline separated into two areas ( as seen in the video 2)
Normal sonohysterogram.

Normal sonohysterogram, showing a smooth internal lining of the uterus. Black colour denotes the fluid in the cavity.

Irregular uterine cavity

The internal lining is irregular. There is posterior homogenous structure which is causing an indentation into the lining suspecting to be a posterior wall fibroid.

Polyp in endometrium.
·  The typical sonographical appearance of an endometrial polyp is that of a well-circumscribed homogeneous lesion that is isoechoic to the endometrium yet preserves the endometrial-myometrial interface.
·  Endometrial polyps can present in diverse manifestations such as cervical polyps, polyps with feeding vessels, multiple polyps or polyps with cystic change.
·  A less common manifestation is a polyp with a broad base of attachment, a polyp which contains cystic components, or a polyp which contains areas of hypoechogenicity/heterogeneity within the polyp.