Ultrasound is one of the most widely used types of diagnostic imaging, yet for many people, the term is inextricably linked with the imaging exams performed during pregnancy to monitor the growth of a fetus or to determine its gender. The fact is, ultrasound exams are used for lots of other indications as well. In gynecology, a special type of ultrasound called saline infused sonography can be especially helpful in evaluating the structure and function of the uterus, especially in women with unusual vaginal bleeding or other symptoms.
What is saline infused sonography?
Also called sonohysterography, saline infused sonography uses ultrasound waves to view the structure of your uterus. Ultrasound uses special sound waves to obtain images of internal organs and other tissues. Unlike X-rays or computed tomography, ultrasound doesn’t use any radiation, which is why it’s safe to use during pregnancy. The waves are emitted by a special wand. As the sound waves painlessly penetrate your skin, they “bounce off” structures inside your body. The ultrasound applicator “catches” the sound waves as they bounce back, then uses that information to create highly detailed videos and still photos of your organs and tissues. Ultrasounds can also be used to capture processes while they’re happening.
Before the imaging exam begins, your uterus is filled with saline (a solution of water and salt). The saline solution “fills” the uterus so it’s easier to view and evaluate during the ultrasound, and it’s also easier to capture video and still images.
Saline infused sonography is typically used to determine the cause of specific symptoms, like pain and unusual vaginal bleeding that might be caused by:
- Adhesions (scars)
- Other benign or cancerous growths
- Congenital defects (abnormalities in the shape or structure of the uterus that have been present since birth)
Saline infused sonography is also frequently used to help determine the cause of infertility or to rule out possible causes of infertility, and it can also help determine the cause of multiple miscarriages.
What to expect during your exam
The exam is typically performed at the end of your menstrual cycle or after menstruation has ended for the month. In menopausal women, the exam can be performed at any time. Before the exam begins, you’ll empty your bladder, remove your clothing from the waist down, and put on a hospital gown. During the exam, you’ll lie on a padded exam table and the lights will be turned down to make it easier for the doctor or technician to see the images on the ultrasound machine.
In some cases, a vaginal ultrasound is performed just before the saline infused sonography portion of the exam. In a vaginal ultrasound, a wand-shaped ultrasound device is gently inserted into your vagina. The wand emits ultrasound energy, just like the applicator that’s used in exams on your belly or other areas of your body.
Next, a thin speculum is used to gently widen the vaginal canal, and a very slim, flexible catheter is inserted through the vagina and into the uterus via the cervix (the opening of the vagina). Once the catheter is in place, a small amount of sterile saline solution is pumped into the uterus, gently expanding the cavity so the contours and the endometrium (the uterine lining) can be easily seen during the scan. The speculum is removed and the ultrasound wand is placed inside the vaginal canal.
The entire exam takes about a half hour. After the exam, you may have some mild cramping and light bleeding that can last for a few hours. Taking an over-the-counter pain reliever before your exam can reduce any discomfort you might have. You might also want to wear a pad immediately after the exam to "catch" any remaining saline fluid that might leak out.
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At Brown Pearson and Guepet Gynecology, we're committed to providing our patients with the care and treatment they need to enjoy the best health possible, at every age and every stage of life. If you're having unusual vaginal or uterine symptoms or if you'd like to learn more about saline infused sonography, book an appointment online today.