Posted October 2, 2022 by Anusha ‐ 4 min read

A sonohysterogram is an imaging procedure that allows your healthcare provider to see inside your uterus. It’s simple, safe and relatively painless. And it can help shed light on what’s causing issues like pelvic pain, irregular bleeding and infertility.

What is a Sonohysterogram?

  • A sonohysterogram is a special kind of ultrasound that lets your healthcare provider see inside your uterus.
  • With a sonohysterogram, an ultrasound records structures and shapes inside your uterus while your uterus is filled with saline.
  • A sonohysterogram can help your provider see problem areas in your uterus and uterus lining (endometrium) that may be causing unwanted symptoms, like bleeding, pelvic pain and infertility.
  • It’s also commonly referred to as an SIS.

Uses of Sonohysterogram

A sonohysterogram can reveal structures inside your uterus that may be causing these symptoms. A sonohysterogram can show:

  • Polyps.

  • Fibroids.

  • Atypical uterus shape.

  • Signs of endometriosis.

  • Signs of endometrial cancer.

  • Blockages in your fallopian tubes.

How does a Sonohysterogram work?

  • The procedure for a sonohysterogram is a lot like the one for a transvaginal ultrasound but images are taken while a few teaspoons of sterile saline is slowly put into your uterus with a small catheter.

  • Like a transvaginal ultrasound, a transducer wand is inserted into your vagina and cervix so that it reaches your uterus.

  • Once inside, the wand releases sound waves that record information about the structures inside your uterus.

  • This information is then used to project an image of what your uterus looks like onto a screen that the radiologist or technician doing your procedure can see.

Procedure of Sonohysterogram

  • Your sonohysterogram should take about 30 minutes.

  • You may feel some minor cramps or discomfort at times during your sonohysterogram.

  • But for the most part, you can expect a quick, painless experience.

  • Your provider will ask you to pee first so that your bladder is empty and to collect a sample for a pregnancy test.

Then, a sonohysterogram happens in three parts. Your provider will:

Do a standard transabdominal and transvaginal ultrasound

  • You’ll be positioned on a table as if you were having a gynecological exam, lying on your back with your knees bent and legs open.

  • Your provider will insert a thin, lubricated wand into your vagina.

  • Once inside, the wand will record images of the inside of your uterus that will appear on a screen.

  • Your provider will gently move the wand so that it records different angles of your uterus and remove it once enough views have been recorded.

  • Depending on the indication for the procedure and if you’ve already had a recent ultrasound, pictures may be taken on top of your abdomen as well.

Add saline to your uterus

  • Your provider will use a tool called a speculum to hold your vagina open so that there’s easy access to your cervix.

  • Your provider will use a cotton swab to clean your cervix.

  • Then, they will insert a thin tube called a catheter into your vagina so that it reaches your uterus.

  • Your provider will put a safe saline solution into your uterus through the catheter.

  • You may feel slight cramping once the saline’s added, but taking pain medicine beforehand can help.

Do a transvaginal ultrasound with saline

  • Your provider will reinsert the wand from the first transvaginal ultrasound and go through the imaging process all over again while the saline fills your uterus.

  • The fluid inside your uterus will allow the ultrasound to pick up more detail when compared to the first ultrasound.

  • Your provider may use a feature of the ultrasound called a doppler to see how blood is moving inside your uterus.

After a Sonohysterogram

You should be able to go home and return to your normal routine after your sonohysterogram.

You may notice the following symptoms. All are harmless.

  • You may have a watery discharge a few hours after your procedure. This is just the saline leaving your body.

  • You may have mild pain or cramping. Anti-inflammation medications like ibuprofen or acetaminophen can help you feel better.

  • You may notice spotting (red or brown discharge from your vagina) over the next few days. This can happen if there’s tissue irritation from the procedure, but it’s nothing to worry about.

What type of results do you get and what do the results mean?

  • Your healthcare provider will contact you once the physician sends over the results from your sonohysterogram.

  • Depending on the results, your provider may prescribe treatments or recommend more imaging, additional views or a different type of imaging procedures to diagnose your condition.

Risks of a Sonohysterogram

A sonohysterogram is low-risk and has few side effects. You may feel uncomfortable at points during the procedure, but taking pain medications beforehand can help. There’s a slight chance of infection, but your provider can take steps to prevent this.

Pay attention to these warning signs that you may have an infection:

  • Fever.

  • Intense pain.

  • Changes in your vaginal discharge.

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