how it works and what it is for
sONOISTEROSALPINGOGRAFIA (SONOISTEROGRAFIA)
There sonohysterography It is an advanced ultrasound examination that allows a accurate assessment of the uterine cavity and fallopian tubes, integrating the information obtained with traditional transvaginal ultrasound. Through the use of an ultrasound contrast medium introduced into the uterus, the examination makes the internal profile of the endometrium clearer and It allows to highlight the presence of new formations or irregularitiesSonohysterography is performed in an outpatient setting and is part of a structured gynecological diagnostic process, especially when intracavitary pathologies or tubal patency problems are suspected.
There sonohysterography It is used to describe in detail the pathologies that affect the interior of the uterine cavity and which, with 2D or 3D vaginal ultrasound alone, can only be suspected. The test allows for the identification of endometrial polyps, small fibroids protruding into cavities, synechiae and irregularities of the inner lining of the uterus, providing a clear view of their location and size. These conditions are often associated with abnormal uterine bleeding (menorrhagia, metrorrhagia), irregular cycles or absence of menstruation, but also with sterility or recurrent miscarriagesThanks to the accurate definition of the uterine walls, sonohysterography helps the gynecologist choose any subsequent treatments, helping to clarify the link between the symptoms reported by the patient and the anatomical alterations found.
an ultrasound support
examination for possible pathologies of the uterine cavity
Evaluation of tubal patency and uterine malformations
A central aspect of sonohysterography is the possibility of evaluating the tubal patency, that is, the capacity of the Fallopian tubes to allow the contrast medium to pass through. This data is essential in the pathways dedicated to thecouple infertility, since patency of the tubes is an essential condition for spontaneous conception.
During the examination, the fluid introduced into the uterine cavity is followed by ultrasound along the tubal course, verifying whether the passage is clear or if there are obstacles that require further investigation. Sonohysterography also helps to exclude or better define uterine malformations and may raise the suspicion of cervico-isthmic incontinence of the cervical canal, sometimes related to repeated miscarriages or premature birth in the second trimester of pregnancy. In this way, the examination takes on an important role in the overall assessment of reproductive health.
Safety, tolerability and side effects
Sonohysterography presents a favorable safety profile and, in most cases, is well accepted by patients. Side effects are rare and usually mild: they may include brief pelvic cramps, minor vaginal bleeding, or a feeling of weakness related to a vagal response. These symptoms tend to resolve spontaneously within a short time.
The ability to obtain detailed information on the uterine cavity and tubal patency without resorting to X-rays or more invasive procedures made sonohysterography a highly useful diagnostic tool, reducing the routine use of hysterosalpingography and hysteroscopy.
Preparation and outpatient context
How is sonohysterography performed?
From a practical point of view, sonohysterography is a short examination, performed in
adequately equipped clinic, with dedicated ultrasound equipment. It requires no complex preparation: the patient is welcomed into the gynecological ward and asked to position herself on the bed with her legs supported by the lateral supports, as for a normal examination. The average duration of the exam is about 15–20 minutes.
Technique and phases of the exam
The technique is relatively simple. After introducing one speculum In the vagina, the gynecologist gently inserts a thin, sterile catheter through the cervical canal into the uterine cavity. After removing the speculum, the transvaginal probe is inserted and the ultrasound contrast medium is injected through the catheter.
The fluid distends the internal walls of the uterus and makes the intracavitary space clearly visible, allowing for the evaluation of:
- the profile of the uterine cavity
- the location and extent of polyps, fibroids or synechiae
- the passage of the contrast medium into the fallopian tubes
There
sonohysterography
It is generally well tolerated: the patient may experience a transient discomfort, comparable to mild or moderate menstrual pain, which tends to reduce spontaneously at the end of the procedure.
supplementary exam
Role of sonohysterography in the diagnostic process
In the context of modern gynecological diagnostics, the sonohysterography It represents a fundamental integration exam when you want to study the causes of abnormal uterine bleeding, amenorrhea, sterility or recurrent miscarriagesThe combination of transvaginal ultrasound, three-dimensional ultrasound, and sonohysterography allows for a complete overview of the uterine morphology, endometrial cavity, and fallopian tubes.
This information allows the gynecologist to construct a clear clinical picture on which to base subsequent diagnostic and therapeutic decisions: from the choice of any targeted surgical intervention to the definition of a specific treatment plan for the couple's infertility. Inserted within a structured evaluation process, sonohysterography contributes to personalize therapeutic strategies and to adapt them to the characteristics of each individual patient.
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