Guide to a Saline Infusion Sonohystogram (SIS) Procedure

Why am I getting an SIS: Saline Infusion Sonohystogram?
Your doctor or gynecologist has scheduled an SIS to further determine the health of your uterus or cervix. Whether you are having an SIS performed to diagnose a problem, or to ensure that your uterus is healthy enough to support a pregnancy, the procedure can be intimidating if not fully understood.

Prepare for your SIS: Saline Infusion Sonohystogram
Be sure to prepare for your SIS procedure by taking a dosage of painkillers before leaving for the doctor’s office, and be ready for a little recovery time when you get home. You will experience cramping, possible mild blood spotting and saline discharge after the procedure.

What to Expect When You Arrive for Your SIS: Saline Infusion Sonohystogram
When you arrive at your doctor’s office for your SIS appointment, you will meet with the ultrasound technician. Your SIS will be performed by your doctor in conjunction with the ultrasound technician, in the room where ultrasounds are performed.

Unlike a traditional external ultrasound, you will not need a full bladder during your SIS or Saline Infusion Sonohystogram. You will actually be asked to use the restroom before starting your SIS procedure, so that you are more comfortable.

Preparing for an SIS Procedure: Saline Infusion Sonohystogram
You will be asked to prepare for your SIS in a similar way that you prepare for a PAP test. You will be asked to undress from your waist down and lie back on an exam table covered with an absorbent pad and put your feet up in stirrups. A cloth will be draped over your abdomen and upper thighs.

While you get positioned, the ultrasound technician will prepare the trans-vaginal ultrasound wand for your SIS. The wand will be covered with a condom and lubricant for easy insertion. If you have allergies to latex or certain types of lubricants, be sure to tell the technician before the procedure begins.

Your doctor will be preparing a small catheter tube which will inject approximately 10cc’s of saline solution into your uterus during your SIS. It can take a few minutes for all the air to be bled out of the catheter tube before the procedure can begin.

The Procedure: Saline Infusion Sonohystogram
Once all the equipment is ready, your doctor will widen your cervix with the use of a speculum. The speculum is slowly inserted through the vaginal opening, and then gently opened to allow a clear path to your cervix and uterus. This is the same type of procedure used at the start of a PAP test. The speculum may be a little cold since it is sterilized at room temperature.

Once the cervix is widened, your doctor will clean your cervix with an antiseptic such as Betadine. There is no discomfort while the cervix is cleaned.

Next, your doctor will begin to insert the catheter tube that will administer the saline solution. The thin plastic tube is inserted into the vagina, past the cervix and into the uterus. You will feel abdominal cramping as the tube is inserted past the cervix. Your uterus’ natural reaction to a foreign object is to push it out, so cramping is a very normal reaction.

Once the catheter is inserted, the ultrasound technician and doctor will work together to position it before injecting the saline solution. The ultrasound technician will slowly insert the trans-vaginal ultrasound wand into the vagina to see the current position of the catheter. Once the catheter is in the correct position, the doctor will inject the saline solution. A small amount of saline solution, approximately 10cc’s, will be injected into the uterus through the catheter tube. The saline solution may feel a little cold since it has been stored in room temperature conditions.

As the saline solution fills the uterus, the ultrasound technician will move the trans-vaginal wand around to get different views of the uterus. They will be able to capture still images and measurements of the uterus for further examination after the SIS procedure.

Repositioning of the catheter, the trans-vaginal ultrasound wand and injections of saline will continue for a few minutes until all areas of the uterus have been examined. Cramping during this part of the SIS procedure may be mild to moderate and cause you discomfort.

Once the SIS exam is complete, the trans-vaginal ultrasound wand will be removed from the vagina, and the catheter tube will slowly be removed from the uterus. Cramping will subside momentarily and saline solution will start to exit the body through the vagina. As you sit up on the exam table, an absorbent pad will catch the saline discharge. Do not be alarmed if some blood spotting is also present.

You will be directed to the restroom where you can re-dress after your SIS. You will want to wear a feminine pad home after your procedure to absorb any excess saline solution or blood spotting.

After your SIS Appointment
Some women experience severe cramping after an SIS procedure. If you begin to feel discomfort, you may want to have someone drive you home. You will want to relax for the next few hours since you will most likely still experience cramping, blood spotting and saline discharge.

You doctor will contact you within a few days with the results of your SIS, or Saline Infusion Sonohystogram.

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