Hysterosonogram (HSN)

HSN which is also called sonohysterogram, is a new minimally invasive technique that involves the slow infusion of sterile saline into a woman’s uterus during ultrasound imaging. HSN allows the doctor to evaluate abnormal growths inside the uterus, abnormalities of the tissue lining the uterus (the endometrium): or disorders affecting the deeper tissue layers. HSN does not require radiation or contrast media, or invasive surgical procedures.

It can be used for the evaluation of the following patients:

  • Peri or postmenopausal women with unexplained bleeding
  • Women whose endometrium appears abnormal during baseline ultrasound imaging
  • Women with fertility problems, infertility is sometimes related to polyps, leiomyomas (fibroids), or adhesions inside the uterus. Adhesions are areas of tissue that have grown together to form bands or membranes across the inside of the uterus.

HSN is useful as a screening test to minimize the use of more invasive diagnostic procedures, such as tissue biopsies and dilatation and curettage (D&C). It can also be used as a follow up after uterine surgery to evaluate its success.

The precautions include:

  • Difficult to perform in clients with certain abnormalities
  • Cervical stenosis, i.e. the lower end of the uterus is narrowed or tightened. It complicates the inserstion of the tube (catheter)
  • Adhesions or large fibroids: Can sometimes block the flow of saline fluid into the uterus.
  • Clients with active PID (Pelvic Inflammatory disease) should not be tested with HSN until the disease is brought under control. Women with chronic PID or heart problems are given antibiotics before the procedure.