Hysterosonography Ultrasound (Sonohysterography): Purpose and Procedure

Hysterosonography or sonohysterography is an ultrasound imaging test that uses soundwaves to produce real-time images of the inside of a woman’s womb(uterus).

This exam is similar to a gynecologic exam and it involves inserting a transducer into the vagina. Hysterosonography should be performed one week after menstruation for effective results and to determine whether the endometrium is normal and also to avoid the risk of infection.

Uses/Reasons for Hysterosonography

Sonography is an important technique for evaluating uterine abnormalities such as vaginal bleeding as it provides real-time images of the uterus.

Hysterosonography can help to evaluate and diagnose conditions such as;

1. Fibroid: An abnormal growth that develops in the womb or uterus.
2. Endometrial adhesions: An infection or injury of the endometrium that causes scar tissues.
3. Polyps: An abnormal tissue growth that grows on the inner wall of the uterus.
4. Endometrial atrophy: This is an after menopause bleeding that is caused by a response to hypo-estrogen. It is an aging-related problem.
5. Malignant masses: An abnormal mass of cell such as tumor
6. Congenital defects: A condition that is present at birth(birth defects).

This imaging technique can also help gynecologists to investigate uterine abnormalities in women who have experienced multiple miscarriages by using images from doppler ultrasound to evaluate blockages and blood clots, pelvic varicose veins, tumors, aneurysms and blood flow in polyps.

Who Performs Hysterosonography?

Hysterosonography is performed by an ultrasound technologist or sonographer. A diagnostic radiologist is a medical professional who is trained to interpret ultrasound images. They specialize in interpreting medical imaging tests including MRI scans, ultrasound, and CT scans.

Preparation for Hysterosonography

To obtain the most accurate result of an imaging test, the steps you take in preparing for the ultrasound scan are very important. You can prepare by doing the following

1. Answering all questions that pertain to your medical history. This includes over-the-counter(OTC) prescriptions and herbal treatments.
2. Adhering to the instructions given to you by the technologist before the ultrasound. These instructions may include emptying your bladder before the ultrasound.

Procedures of Hysterosonography

Hysterosonography ultrasound is performed in a hospital. The procedure of an abdominal ultrasound takes less than 30 mins generally. Steps include;

1.  Lying down on your back with your feet stirrup on a table in the ultrasound room which is usually dark, to enable easy reading of the ultrasound images on the ultrasound screen.
2. A special gel will be applied to the transducer which is already covered with a protective cover and then inserted into the vagina. The gel will help to reduce friction and help the transducer slide across your skin. It is the transducer that sends and receives soundwaves to produce the image on the ultrasound screen.
3. The technologist will only insert 2-3 inches of the transducer into your vagina.
4. The technologist may occasionally press the transducer down. While he’s doing this, you might be asked to change your position for a short while. This will enable the technologist to have clear imaging that will help diagnose your condition.
5. The transducer is removed and a sterile speculum will be inserted. Then the cervix is cleansed and a catheter is inserted into the uterine cavity.
6. After the catheter is in place, the speculum will be removed and the transducer will be re-inserted into the vagina.
7. You may be asked to wait for a short while. Then the diagnostic radiologist will check if the imaging was complete.
8. After an imaging test, the patient is usually asked to go home.

Benefits of Hysterosonography

Some known benefits of hysterosonography are listed below:

1. It is not painful although it may be uncomfortable temporarily.
2. It is noninvasive which means that there are no injections or needles.
3. It can help to detect the potency of the fallopian tube
4. It is less expensive and easy to use compared to other imaging methods.
5. It can help to detect a change in the appearance of an organ or tissue in the vagina.
6. It is widely available compared to other imaging methods.
7. It is completely safe and it uses sound waves not radiation.
8. It is a good tool for real-time imaging of the endometrial lining and the uterus.
9. It provides a more clear picture of soft tissues that did not show up clearly on x-ray.
10. It can ensure the removal of fibroids and polyps during surgery and can also prevent unnecessary surgery.

Limitations of Hysterosonography

Though hysterosonography is painless and has no known harmful effect on the human body, it has a few limitations. Some of these limitations are listed below;

1. It should not be performed on a pregnant woman.
2. It should not be performed if the woman has an active pelvic inflammatory disease.
3. It may be difficult to insert the catheter into the cervical canal of women who suffer from stenosis of the cervix.