What Is A Hysterosonogram Procedure Uses Risks?

A hysterosonogram is an ultrasound procedure that uses sterile saline to expand the uterine cavity so a doctor can see the inside of the uterus clearly. It is also called saline infusion sonography or SIS. The procedure helps evaluate abnormal bleeding, check for polyps or fibroids, and assess the uterine lining in women who may be experiencing infertility. It is a low-risk, outpatient test that usually takes less than 30 minutes.

What Is A Hysterosonogram Procedure Uses Risks?

A hysterosonogram combines a standard transvaginal ultrasound with a small amount of sterile salt water. The saline gently expands the uterine cavity, which separates the walls of the uterus. This separation lets the ultrasound see structures that a regular ultrasound cannot show clearly.

Without the fluid, the front and back walls of the uterus sit close together. Polyps, fibroids, or scar tissue can hide in the folds. The saline creates a clear space, making these abnormalities visible. This is why the procedure is more sensitive than a routine transvaginal ultrasound for evaluating the uterine lining.

Why Would a Doctor Order a Hysterosonogram?

Doctors most often order this test for abnormal uterine bleeding. This includes heavy periods, bleeding between periods, or bleeding after menopause. The procedure helps determine whether a growth inside the uterus is causing the bleeding.

It is also commonly used during infertility evaluations. Before starting fertility treatment, doctors want to confirm the uterine cavity is normal. A hysterosonogram can detect polyps, fibroids that bulge into the cavity, or scar tissue that might interfere with implantation.

Doctors also use it to follow up on an abnormal finding from a routine ultrasound. If a standard scan shows a thickened lining or an unclear shadow, the saline infusion provides a more detailed view.

How to Prepare for a Hysterosonogram

Preparation is simple. Your doctor will schedule the test during the first half of your menstrual cycle, typically between days 5 and 10. At this time, the uterine lining is thin, which makes it easier to see abnormalities. You cannot have the test while you are actively bleeding heavily.

You should not schedule the procedure if you might be pregnant. Most doctors require a negative pregnancy test before the procedure. This is a precaution because the test introduces fluid into the uterus, and its safety during early pregnancy has not been established.

You may be advised to take an over-the-counter pain reliever about an hour before the appointment. Some doctors prescribe a mild sedative for anxious patients, though most women tolerate the procedure well without one.

What Happens During the Procedure

You will lie on an exam table with your feet in stirrups, similar to a pelvic exam. The doctor inserts a speculum to see the cervix. After cleaning the cervix, a thin, flexible catheter is guided through the cervix into the uterine cavity.

The speculum is removed carefully so it does not dislodge the catheter. Then the ultrasound probe is inserted into the vagina. Sterile saline flows through the catheter into the uterus while the ultrasound images are recorded.

Most women feel mild cramping when the fluid fills the uterus. The cramping is similar to menstrual cramps and usually subsides within a few minutes. The entire imaging portion takes less than 10 minutes. After the images are complete, the catheter is removed, and the saline drains out naturally.

What Conditions Can a Hysterosonogram Detect?

Several common conditions are visible on a hysterosonogram. The most frequently detected findings include:

• Endometrial polyps – soft, often benign growths attached to the uterine lining
• Submucosal fibroids – fibroids that grow into or bulge into the uterine cavity
• Uterine scar tissue – adhesions that can form after surgery or infection
• Uterine septum – a band of tissue dividing the uterine cavity
• Thickened endometrial lining – which may require further evaluation

The test cannot evaluate the ovaries well. It is specifically designed to look at the inside of the uterus. If ovarian concerns exist, a standard pelvic ultrasound is a better tool.

What Are the Risks and Side Effects?

Hysterosonogram is a safe procedure with low risk. The most common side effect is mild cramping during and shortly after the test. Some women experience light spotting for a day or two afterward. This is normal and not a cause for concern.

Infection is rare but possible. The risk is low because the equipment is sterile and the cervix is cleaned before insertion. However, any instrument passing through the cervix carries a small risk of introducing bacteria into the uterus.

Serious complications are uncommon. Perforation of the uterus is possible but extremely rare with this procedure because the catheter is soft and thin. Allergic reactions to the saline are essentially nonexistent because saline is simply sterile salt water.

What Do the Results Mean?

A normal result means the uterine cavity has a smooth, regular shape with no visible growths or adhesions. The uterine lining appears uniform in thickness. If you had the test for abnormal bleeding and the result is normal, your doctor may consider hormonal causes or other factors.

An abnormal result shows one or more findings. Polyps and fibroids are the most common abnormalities found. Not all of these require treatment. Small polyps or fibroids that do not cause symptoms may simply be monitored. Larger ones, or those causing heavy bleeding, may be removed surgically.

If the test shows a thickened lining, your doctor may recommend a biopsy. A hysterosonogram shows the structure but cannot tell whether cells are normal or abnormal. Only a tissue sample can provide that information.

Hysterosonogram vs. Other Uterine Tests

Several tests evaluate the uterine cavity, and each has strengths and limitations. A standard transvaginal ultrasound shows the uterus and ovaries but cannot reliably detect small polyps or fibroids inside the cavity.

Hysteroscopy uses a small camera inserted through the cervix to look directly at the uterine lining. It provides the most detailed view and allows for biopsy or removal of growths during the same procedure. However, it is more invasive and typically requires anesthesia.

Hysterosalpingography, or HSG, uses dye and X-rays to evaluate the uterine cavity and fallopian tubes. It is often used in infertility workups because it shows whether the tubes are open. A hysterosonogram does not evaluate the fallopian tubes.