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April 18, 2014  
EDUCATION CENTER: Diagnostics
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  • Hysterosonogram


    Overview:
    Reviewed by Jonathan Smith, MD

    A hysterosonogram is a procedure that allows doctors to examine the inside of the uterus and check for abnormalities with the use of ultrasound, which uses sound waves to produce an image. Unlike the ultrasound or "sonogram" that is used to view the developing fetus during pregnancy, this type of ultrasound is performed by inserting a ultrasound probe into the vagina.

    Detailed Information:
    A hysterosonogram can be a valuable diagnostic test for a wide variety of problems. It can identify abnormalities in the uterus, which can be very useful in finding underlying causes for those who suffer from dyspareunia (pain during sexual intercourse), reproductive problems such as infertility or frequent miscarriage, or menorrhagia (uncommonly heavy or painful menstrual periods), and can help doctors identify uterine fibroids, polyps, or other growths, abnormalities, or lesions in the uterine wall.

    To undergo the procedure, a patient must not be menstruating, so doctors typically request that the patient call to schedule the appointment on the first day of her period, to ensure that she can come in for the procedure before she begins menstruating the following month. It is also recommended that the procedure be performed before mid-cycle, because the uterus is more easily "seen" by the ultrasound device at this point, and there is a much lesser chance that a patient will be pregnant. The patient is generally asked to drink a quantity of water and not to urinate for about an hour before the procedure, because a full bladder helps to position the uterus so that it can be viewed more easily.

    To perform the procedure, the doctor begins by inserting an ultrasound device into the vagina, and checking for abnormalities in the uterus and ovaries. Then, a device called a speculum is used to open the vagina and expose the cervix. The doctor cleans and possibly numbs the cervix, then inserts a small tube through the cervix and into the uterus. The tube pumps a harmless, sterile saline solution into the uterus, which expands the uterus and makes it easier to see. Then, the doctor uses the ultrasound probe in the vagina to generate an image of the expanded uterus for a few minutes. After examining the image of the uterus, the doctor removes the probe, and the saline solution drains from the uterus. The procedure is usually not painful, but the patient may experience cramps similar to those that happen during her period when the tube is inserted into the cervix or when the uterus is filled with saline solution. If desired, an over the counter pain remedy, such as Advil or Tylenol, may be taken before the procedure to maximize comfort. This, however, should be cleared with the physician first.

    In the day or so after the procedure, the patient may experience a little cramping, which can also be controlled with over the counter pain-killers. A small amount of sticky vaginal discharge is another common after-effect as remaining traces of fluid drain from the uterus, and some patients may experience very light bleeding. Results of the procedure are usually available within a few days after it is completed.

    Last updated: 06-Jun-07


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