A saline sonogram, also known as sonohysterography (SIS), is a specialized medical imaging procedure. This diagnostic test uses ultrasound technology to create detailed pictures of the inside of the uterus without radiation. Its primary purpose is to provide a clear view of the uterine cavity, which is often difficult to assess with a standard ultrasound.
Purposes of a Saline Sonogram
A saline sonogram investigates various conditions affecting the uterus, offering a more detailed assessment than conventional ultrasound. It is frequently used to understand abnormal uterine bleeding, including spotting or bleeding after menopause. The procedure helps identify structural abnormalities within the uterine cavity, such as uterine fibroids (non-cancerous growths) and endometrial polyps (overgrowths of cells). It can also assess for scar tissue (Asherman’s syndrome) and evaluate the uterus in cases of infertility or recurrent miscarriages, distinguishing between different types of uterine abnormalities like atypical shapes or septa.
The Examination Process
A saline sonogram is typically an outpatient procedure, usually completed within 30 minutes. The examination begins with the patient lying on their back, similar to a routine pelvic exam, with knees bent. An initial transvaginal ultrasound is often performed without saline to establish baseline images of the uterus and ovaries.
Following this, a speculum is gently inserted to visualize and clean the cervix. A thin, flexible catheter is then carefully advanced through the cervix into the uterine cavity. Once the catheter is in place, the speculum is removed.
The transvaginal ultrasound probe is re-inserted, and sterile saline solution is injected through the catheter into the uterus. This saline infusion expands the uterine cavity, allowing for clearer visualization of the endometrial lining and internal structures. The ultrasound captures real-time images as the saline fills, enabling the healthcare provider to examine the uterine interior. The saline infusion and imaging typically takes only a few minutes.
Preparation and Aftercare
Preparation for a saline sonogram involves specific timing. It is usually scheduled after menstruation but before ovulation (between day 5 and 10 of the menstrual cycle) to ensure a thin endometrial lining and avoid potential early pregnancy. It is not performed if pregnancy is suspected or pelvic inflammatory disease is present.
Patients are advised to take an over-the-counter pain reliever, like ibuprofen, 30-60 minutes before to manage discomfort. Sometimes, antibiotics may be prescribed to prevent infection. Patients are asked to empty their bladder before the exam and may consider wearing an absorbent pad afterward.
During the procedure, patients may experience mild cramping or pressure as the catheter is inserted and saline is infused. This discomfort is generally well-tolerated.
Following the saline sonogram, mild cramping, light spotting, or watery discharge is common as saline drains. Most patients can resume normal activities immediately. Contact a healthcare provider for severe pain, fever, heavy bleeding, or foul-smelling vaginal discharge, as these could indicate a complication. Results are typically reviewed with the patient or sent to the referring physician.