Chapter 250 Sonohysterography
DESCRIPTION
Sonohysterography is a technique of ultrasonographic visualization of the uterine cavity using saline as a contrast and distending media. The technique is also known as saline infusion sonohysterography (SIS).
INDICATIONS
Similar to those for hysteroscopy or endometrial biopsy; dysfunctional uterine bleeding, postmenopausal bleeding, menorrhagia, infertility (selected cases), or recurrent abortion, endometrial or pelvic infections (e.g., tuberculosis), missing intrauterine contraceptive device, or other situations where viewing the endometrial cavity can establish a diagnosis. The technique is particularly adept at documenting endometrial polyps, submucous leiomyomata, and intrauterine adhesions.
CONTRAINDICATIONS
Acute bleeding; acute cervical, uterine, or pelvic infection; known uterine or cervical cancer; pregnancy (known or suspected); recent uterine perforation; vaginitis (relative).
REQUIRED EQUIPMENT
TECHNIQUE
When possible, sonohysterography should be performed during the proliferative phase of the menstrual cycle when the endometrium is thinnest. The discomfort of sonohysterography may be decreased by premedicating with a single oral dose of a nonsteroidal anti-inflammatory agent given in doses usually used to treat dysmenorrhea.
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