Ultrasound imaging of the uterus, also known as sonohysterography or saline infusion sonography, is a specialized, minimally invasive ultrasound technique. Sonohysterography provides images of the inside of a woman’s uterus.

A Doppler ultrasound study is usually an integral part of this type of ultrasound examination. Doppler ultrasound is a special ultrasound technique that evaluates blood flow through a blood vessel.

Ultrasound imaging uses a small probe, called a transducer, and gel placed directly on the skin. High-frequency sound waves travel from the probe, through the gel, into the body. The probe collects the sounds that bounce back. A computer uses those sound waves to create the images for the exam.

Ultrasound is painless and non-invasive.

When would I get an Ultrasound of the Uterus?

Your medical provider may recommend an ultrasound of the uterus to detect the cause of unexplained vaginal bleeding that may result from:

  • polyps
  • fibroids
  • endometrial atrophy
  • endometrial adhesions (or scarring)
  • malignant lesions/masses
  • congenital defects

Sonohysterography is also used to investigate uterine abnormalities in women who experience infertility or multiple miscarriages.

What Will I Experience?

A baseline transvaginal ultrasound procedure is performed first to view the endometrium, which is the lining of the uterus, its thickness and any associated ovarian abnormality. Transvaginal ultrasound is performed very much like a gynecologic exam.

It involves the insertion of the transducer into the vagina after you empty your bladder. The tip of the transducer is smaller than the standard speculum used when performing a Pap test. A protective cover is placed over the transducer, lubricated with a small amount of gel, and then inserted into the vagina. Only two to three inches of the transducer end are inserted into the vagina.

Following the baseline exam, the transvaginal probe will be removed and a sterile speculum will be inserted as you lie on your back with your knees bent or your feet in stirrups. The cervix will be cleansed and a catheter will be inserted into the uterine cavity.

Once the catheter is in place, the speculum will be removed and the transvaginal probe will be re-inserted into the vaginal canal. Sterile saline will then be injected through the catheter into the uterine cavity as ultrasound is being performed.

You may feel occasional cramping as a result of the introduction of the saline. Over-the-counter medication should be sufficient to minimize any discomfort associated with the procedure. You may have vaginal spotting for a few days after the procedure, which is normal.

Typically, ultrasound imaging of the uterus takes approximately 90 minutes to complete.