Sonohysterogram
When women in their 20s and 30s have abnormal uterine bleeding, the cause is almost always “hormone imbalance.” Such women in the past were often offered hormonal therapies, most commonly in the form of low-dose birth control pills. But as women reach their 30s and 40s, concerns about endometrial abnormalities such as polyps, fibroids, precancerous and cancerous lesions increase.
Therefore, for the last 50 years, women of this age with abnormal bleeding have been diagnosed with Dilation & Curettage (D&C) hysteroscopies, endometrial biopsies, and other invasive procedures to exclude serious abnormalities. Not finding an abnormality, they have been left with a diagnosis of “hormone imbalance.” During the past few years, transvaginal sonohysterography (TVSH) has often been used as a less traumatic yet equally accurate office-based alternative.
Sonohysterography is a valuable technique for examining the endometrial cavity and fallopian tubes. It involves instilling a small amount of normal saline into the endometrial cavity with a flexible catheter while simultaneously visualizing the endometrial surface and its thickness with transvaginal ultrasound.
Indications: When it is Used?
- Abnormal vaginal bleeding
- Unexplained infertility
- Recurrent pregnancy loss
- Pre- and post-operative assessment of uterine pathology
Benefits:
- Enhances the endovaginal ultrasound examination of the uterine cavity.
- It is performed easily and rapidly, and is extremely well tolerated by patients and virtually devoid of complications.
- It can prevent further invasive procedures in many patients, including unnecessary D&C.
- Optimizes the preoperative triage process for those patients who may require treatment.
Precautions:
- Sonohysterograms should not be performed if you are pregnant or suspect that you might be pregnant.
- Any pelvic infection, pelvic inflammatory disease (PID) or hydrosalpinx/mucopyosalpinx (dilated fallopian tubes) should be properly treated and eliminated prior to this procedure. Please ask your doctor for an antibiotics prescription to take prior to the sonohysterogram.
