Saline Infusion Sonography
Saline Infusion Sonography or SIS has many purposes.
Saline Infusion Sonography Explained
Saline Infusion Sonography (SIS) checks the uterine cavity by injecting a small amount of fluid (sterile saline) into the uterus through a thin catheter and observing it with ultrasound.
The test is sometimes performed as part of the investigation of abnormal uterine bleeding, fertility problems, fibroids and to show the uterine shape.
The procedure should not be performed if you are, or may be, pregnant at the time. It should also be delayed until following treatment of suspected or confirmed pelvic infection.
Image courtesy of Mayo Foundation for Medical Education
How is the procedure performed?
On the day, a transabdominal or transvaginal ultrasound scan may be required immediately before the procedure. You will be advised at the time if this is the case.
Before the procedure, you will need to undress from the waist down and empty your bladder completely. When lying on the bed, you will be covered with a sheet, and your legs placed in stirrups.
The external genitals will be washed with an antiseptic solution. A speculum will be passed into the vagina, and the cervix also washed with antiseptic. A thin plastic catheter (tube) is passed into the cervix.
A plug along the length of the catheter fits into the cervix opening to help retain the fluid. Alternatively, a different catheter, with small balloon inflated at its tip is used. The speculum is then removed, and a transvaginal ultrasound is performed as the saline is injected. You will be advised of what is happening as the procedure occurs.
Is it painful?
There is some discomfort associated with the procedure, similar to period pain. The intensity of the discomfort varies between women, but is not usually too painful.
It is strongly recommended to take 2 tablets of an anti-inflammatory medication (such as Ponstan, Nurofen or Naprogesic) an hour before your appointment. This is helpful, not only to minimise crampy discomfort, but also to relax the uterus, enabling the procedure to be performed with greater ease. If you are unable to take anti-inflammatories, due to allergies, asthma or other reasons, use of simple analgesics, such as Panadol is an alternative.
- Read more about what to expect with a Gynaecological Ultrasound.
- Have questions for either pregnancy or gynaecology scans? See our FAQs.
- Have an appointment with us and want to know what to expect? See our patient practical information section.
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Are there any risks?
The most common ill-effect is the discomfort. However with use of an anti-inflammatory beforehand, most women with find the procedure not too unpleasant.
There is a small risk of introducing infection into the uterus and pelvis. If you become unwell in the days or weeks that follow the procedure, with symptoms of fevers, loss of appetite, lower abdominal or pelvic pain, or unusual discharge, please see your referring doctor or your local GP at your earliest convenience.
Occasionally, the cervix will not allow the catheter to be passed, or fluid is not retained sufficiently in the cavity to permit assessment.
Rarely, handling of the cervix results in a reflex fall in blood pressure (called cervical shock). This can lead to feeling faint and dizzy or passing out. If you become faint, or lose vision or hearing during the procedure, please alert the staff immediately.
How will I feel after the procedure is over?
You will probably have some persisting period-like cramps for a few hours. Using further simple analgesics, or local heat (hot water bottle or wheat bag) can help.
Some women prefer to have someone with them to drive them home, but it is quite reasonable to drive yourself if you need to. Returning to work immediately after the procedure is possible if required, but you may prefer to have a restful afternoon instead.
You should expect some dark vaginal discharge from the vagina for a short period of time, due to the Betadine antiseptic. We suggest you wear dark undies and bring a panty-liner to wear afterwards.
If you develop symptoms of possible infection, please see your referring doctor or local GP as early as possible.
How do I make a booking?
Complete the HyCoSy/SIS history sheet which follows, then fax it along with your referral to 08 9481 4080.
Call QDOS Ultrasound Perth on the first day of your next period. Available appointments between your period and anticipated ovulation will be offered to you. Please abstain from intercourse from the first day of your period, until the procedure has been performed.