Hysterosonogram (HSN) or Sonohsterogram (SHG)
This procedure is known by a few names: Hysterogsonogram (HSN) or sonohysterography (SHG) is a procedure to evaluate the uterus and the shape of the uterine cavity. SHG uses ultrasound and sterile fluid to show the uterus and endometrial (uterine lining) cavity. The ovaries are also seen at the time of SHG. The purpose is to detect any abnormalities. The HSN provides the best imaging of the contour of the uterine cavity. It is an ultrasound where fluid is injected into the uterus. The test is usually scheduled between cycle days 5-11. If you are on birth control pills, this test may be completed any time. The HSN evaluates the uterine cavity and can also, sometimes, check the patency of the fallopian tubes. This test is performed at our Chicago office location. At this appointment, you will also have a physical exam if not already completed at a previous appointment.
WHY IS SHG PERFORMED?
o HSN can be done to investigate conditions such as abnormal uterine bleeding, infertility, and recurrent miscarriage. HSN can also be performed to see the structure of the uterus.
o This may be done in women with congenital abnormalities (birth defects) of the uterus, before and after surgery on the uterus, or to detect problems that appear later in life such as polyps or suspected scar tissue inside the uterus.
o HSN may also help check uterine abnormalities found during a routine ultrasound.
o HSN should not be performed in women who are pregnant or who are suspected to be pregnant. SHG should also not be performed in women with an active pelvic infection.
HOW IS HSN PERFORMED?
o HSN is usually done after the menstrual period finishes. In women not menstruating (such as those on medications suppressing the menstrual cycle, post- menopausal women, etc.), it may be done at any time.
o The procedure begins with an ultrasound examination using a probe placed in the vagina.
o Next, a speculum is introduced and a narrow catheter is placed in the vagina, through the cervix, and into the uterine cavity. The ultrasound examination is continued while sterile saline (salt water) is put into the uterus.
o The saline solution fills the uterus, helping to outline the uterine walls and cavity. This shows abnormalities such as fibroids, polyps, or scar tissue inside the uterus
WHAT ARE THE RISKS AND COMPLICATIONS?
o HSN is a very safe procedure and usually is performed without incident. Serious complications are rare. The most common serious complication with SHG is pelvic nfection. However, this occurs less than 1% of the time and usually occurs when a woman also has a block or infection of the fallopian tubes.
o HSN may also cause cramping, spotting, and vaginal discharge. Some women have cramping for several hours after the procedure. It is often recommended to take a medication such as ibuprofen before this test. Some doctors may also prescribe stronger pain medication and/or antibiotics before the procedure. You should call your doctor if you experience pain or fever in the 1–2 days after the SHG.
Your physician will determine the best test(s)for you based on your medical history. Some patients who completed an HSG will also need an HSN based on the results of the HSG. Small irregularities that may not be identified by the HSG can be detected by this evaluation. By the same token, some patients who completed an HSN will also require an HSG if there are unanswered questions regarding the fallopian tubes. As you complete either test, your physician will share the results with you and let you know if more testing is recommended.