Sonohysterography is a technique developed to gain a better image of your uterine cavity.
We do this by using an infusion of sterile saline through a soft plastic catheter placed inside your cervix in conjunction with an internal ultrasound. The saline infusion will expand your uterine cavity which provides us with an excellent contrast to the lining and therefore a good visualisation of uterine and endometrial pathology.
This technique may also be used to assess your fallopian tubes by demonstrating how the fluid spills into your pelvis. Using Colour Doppler imaging we can monitor the movement of the fluid as it passes along the fallopian tubes.
Why is it performed?
Reasons you may have been referred for a Sonohysterogram include:
- Abnormal bleeding both pre and post menopausal
- As an investigation of infertility
- Recurrent miscarriage
- Endometrial assessment for patients on Tamoxifen therapy
- Suggestion of a mass in the endometrial cavity on ultrasound
By having a Sonohysterogram, we can assess the nature, size, vascularity and location if there is a mass in your uterine cavity, this is helpful information before definitive surgery.
In a number of cases, the Sonohysterogram can eliminate the need for further investigation when no significant endometrial pathology can be found. This is particularly important in cases of bleeding around the time of menopause where a hormonal disturbance is the most common cause and does not benefit from surgery.
If you are undergoing investigation for infertility, you may find that you have polyps in your uterine cavity, this could be one of the reasons you might be struggling to conceive, we can help to diagnose this by a Sonohysterogram and subsequent assessment . Having a Sonohysterogram is also particularly important if you are starting an IVF program, as these polyps can limit your success.
Patients on long term Tamoxifen therapy for breast cancer have been shown to develop polyps and thickened uterine linings (endometrial hyperplasia) as well as occasionally developing endometrial cancer. Although this is a rare complication, it is a notable side effect of Tamoxifen.
More commonly, however there are changes in the muscular layer just under your uterine lining which is distinguishable from endometrial hyperplasia by sonohysterography but not on standard internal ultrasound.
Is there any discomfort?
There can be discomfort associated with this procedure especially if you suffer from heavy periods. Taking an analgesic such as Naprogesic (two tablets) half an hour before the procedure is a good idea. If you do suffer from heavy periods, we recommend that you don’t drive home after this procedure, perhaps ask a support person for a lift or get a taxi if need be.
This is a simple procedure, able to be performed in the ultrasound room. It does not require sedation and is useful before hysteroscopy and dilatation and curettage (D & C).
What to Expect after a Sonohysterogram
All of our doctors are experienced in performing this procedure and the risks are minimal. Most women experience no problems following their procedure. However it is good to be informed about what is regarding as normal and what is considered abnormal following a Sonohysterogram:
It is NORMAL for you to experience the following:
- Abdominal cramping for up to an hour following the procedure
- Light bleeding for 3-4 days, which should be controlled by wearing a panty-liner or pad
- Please do not use a tampon (to minimise the risk of infection)
It is NOT NORMAL for you to experience the following:
- Foul-smelling discharge
- A fever greater than 38 degrees Celsius
If either of these symptoms occur, it could be a sign of infection. Please contact the Ultrasound clinic and doctor of your procedure, or please contact your referring doctor/GP to arrange appropriate assessment and to start treatment.
Additionally, it is not necessary to abstain from intercourse following the procedure.
If you have any more questions regarding the Sonohysterogram procedure, please get in touch with our staff on 1300 557 226, remember it is a safe low-risk procedure, valuable in providing further direction for diagnosis and treatment of infertility.