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:
- 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.
- 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.