Saline Sonohysterogram (SIS)

A saline sonohysterogram (SIS) is a special type of sonogram. The purpose of this procedure is to look at the lining inside your uterus and determine how thick it is and whether or not you have a polyp inside. A polyp is a small piece of tissue that forms inside the lining of the uterus. It is almost always benign but can cause you to have vaginal bleeding. This test will also help show your doctor if you have any fibroids in your uterus and where they are in relation to the lining of the uterus.

The first part of this test is to perform a vaginal sonogram where a small wand is inserted just inside the vagina and takes pictures of the uterus and ovaries. Patients generally feel “pressure” during this part of the test but should not feel pain. After the sonogram is complete, the sonographer will show images to your doctor and find out if you need to have the second part of the test.

The second part of the test involves the doctor coming into the sonogram room and putting a little water into your uterus to further evaluate the lining. This is usually performed if:

• your lining is thicker than 5mm;
• you have multiple fibroids; or
• your lining is not seen clearly on the regular sonogram

Your doctor will begin this part of the test by inserting a speculum into the vagina; this is the same instrument they use when they do your pap smears. Once the speculum is inserted your doctor then cleans the cervix with a cotton ball and an iodine solution. Your doctor will then insert a small flexible tube that looks like a spaghetti noodle into your cervix.

You may feel some cramping at this point in the exam. Once the tube is in place, your doctor will remove the speculum, and the technician will do a short sonogram while your doctor puts a small amount of water into your uterus through the tube. You may feel some cramping while the water is going in. After taking a couple pictures your doctor will remove the tube and the ultrasound probe and have you sit up on the end of the table.

After finishing the exam we will let you get cleaned up in the changing area before talking to your doctor. There will be towelettes, tissues, pads, and panty liners available. Most of the water will drain out as soon as you sit up on the table, however sometimes a little will trickle out later. It is also common for patients to have a little spotting or light bleeding following the exam and sometimes a brownish yellow discharge will appear from the soap your doctor uses to clean your cervix. We recommend that you wear a pad or panty liner for at least a couple hours after the exam.

Once you have finished dressing you will be taken to an office where your doctor can discuss your results and make a recommendation on further treatment, if necessary.