Sonohysterography
Sonohysterography is a specialized procedure by which fluid, usually sterile saline, is installed into the uterine cavity, and gynecologic sonography performed at the same time. It was developed to better image the uterine cavity. The saline infusion distends the uterine cavity and provides an excellent contrast to the lining, giving improved visualization of uterine and endometrial pathology.
This technique may also be used to assess the fallopian tubes by demonstrating fluid spill into the pelvis. Colour Doppler imaging demonstrates the movement of ultrasound contrast medium within the tube.
This procedure is performed for the following possible reasons:
- Abnormal uterine bleeding both pre and post menopausal
- Investigation of infertility and recurrent miscarriage
- Endometrial assessment for patients on Tamoxifen therapy
- Suggestion of a mass in the endometrial cavity on ultrasound
This is a simple procedure, able to be performed in the ultrasound room. It does not require sedation or analgesia and is useful before hysteroscopy and dilatation and curettage (D & C).
In a number of cases, it can eliminate the need for further investigation when no significant endometrial pathology can be demonstrated.
This is particularly important in cases of bleeding around the time of menopause where a hormonal disturbance is the most common cause and does not benefit from surgery.
Patients undergoing investigation for infertility have a high incidence of polyps in the uterine cavity which may be responsible for their inability to conceive. This is particularly important in those patients starting on IVF programmes, as these polyps may limit their success.
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