Saline infusion sonohysterography (SIS), a.k.a. sonohysterogram is an ultrasound test using fluid to evaluate the uterine cavity. Fluid instillation into the uterus coupled with high resolution transvaginal probes allows tremendous diagnostic enhancement with an inexpensive, simple and well-tolerated office procedure. The goal of SIS is to visualize the endometrial cavity in more detail than is possible with routine transvaginal sonography.
The most common indication for SIS is abnormal uterine bleeding in both premenopausal and postmenopausal women. Other indications include but are not limited to evaluation of:
- Infertility and recurrent miscarriages.
- Congenital abnormalities of the uterine cavity
- The uterine cavity, especially with regard to uterine myomas (fibroids), polyps and synechiae (scar tissue).
SIS should not be performed in a woman who is pregnant or who could be pregnant. This is usually avoided by scheduling the examination in the early phase of the menstrual cycle—usually between days 5 and 11. SIS should also not be performed on patients with a pelvic infection. In such cases, patients may be placed on an antibiotic regimen prior to the procedure.
There is no prep for SIS. Patients should arrive with an empty bladder for the procedure. Although, there is little to no discomfort for the test, prophylactic ibuprofen may be taken one hour prior to the procedure.
The procedure is simple. A preliminary routine transvaginal ultrasound with measurements of the uterus and ovaries should be performed prior to SIS. A speculum is used to allow visualization of the cervix. The physician will then cleanse the cervix with betadine, an iodine solution. A very thin, flexible catheter is then inserted through the cervical canal into the uterine cavity. Sterile saline solution is then instilled slowly by manual injection under real time sonographic imaging. Approximately 1-2 tablespoons of saline is injected. Once imaging is complete, the catheter and speculum are removed along with the ultrasound probe.
The SIS portion of the exam takes about 5 minutes to complete. During the procedure, Dr. Rainville will point out to you all that she is visualizing on the ultrasound screen. She will discuss with you what she does or does not see; your results are delivered to you right in the ultrasound suite. You needn’t wait days or weeks for results. Upon completion of the test, a thin minipad will be provided for you as a slight orange discharge (due to betadine cleansing) may be present for a few hours.
Easy. Simple. Fast results with further direction from Dr.Rainville, all during the same appointment. SIS is an easily tolerated procedure to evaluate your uterine cavity and get some answers in a timely manner.
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