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Hysterosonography, also called Sonohysterography or Saline Infusion Sonography, is a minimally invasive Ultrasound exam that provides images of the inside of the uterus to help diagnose the cause of abnormal vaginal bleeding.
This examination is different from a Hysterosalpingogram in which sterile contrast (material which can be seen on an X-ray) is introduced into the uterine cavity, but a similar catheter placement procedure, often to help find the cause of infertility or confirm position of fallopian tube occlusion devices (Essure) to prevent fertility.
The best time to have a Hysterosonogram is within 7-10 days after the start of your menstrual cycle when the lining of the uterus is at its thinnest. For post-menopausal patients, this procedure may be scheduled routinely.
Prior to the Hysterosonogram, a Transvaginal Ultrasound will be performed to establish a baseline for the thickness of the endometrium (lining of the uterus) and determine any abnormalities that may exist. This type of Ultrasound is similar to a gynecologic exam, which involves you lying on your back with your feet in stirrups while a transducer is inserted into the vagina, allowing images of the uterus and ovaries to be taken from different angles. Once the Transvaginal Ultrasound is complete, you will remain in the same position for the Hysterosonogram. During this exam, a speculum will be used to dilate the vagina so that the cervix can be seen and cleansed. Then, a catheter is placed into the uterine cavity to transport sterile saline into the uterine cavity. The speculum will be removed and the transvaginal probe will be reinserted into the vagina to capture more detailed images of the uterine cavity as it is filled with sterile saline. The entire procedure takes about 30 minutes.
Once the exam is complete, you should be able to immediately resume your normal activity level. You may have mild discomfort that can be minimized with over-the-counter medication. You may also see vaginal spotting for a few days after the procedure. This is completely normal and should not cause any concern. If this continues for more than a few days, contact your physician right away.