Insight Diagnostic Imaging


Transvaginal Sonohysterography (TSH)

What is Transvaginal Sonohysterography (TSH)?

Transvaginal Sonohysterography (TSH), also called hysterosonography is a noninvasive procedure involving the slow infusion of sterile saline solution into the uterus during ultrasound imaging. This is a procedure which evaluates abnormal growths inside the uterus and abnormalities of the tissue lining the uterus (endometrium). TSH does not require either radiation or contrast media or invasive surgical procedures.

Why is TSH important?

This exam is a noninvasive procedure which is safe and causes most patients little discomfort. It is used to evaluate the following:

  • Peri- or postmenopausal women with unexplained vaginal bleeding.
  • Women whose endometrium appears abnormal during ultrasound imaging.
  • Women with fertility problems. Infertility is sometimes related to polyps, fibroids or adhesions (bands or membranes) inside the uterus.
  • Women receiving Tamoxifen therapy for breast cancer.

TSH is a valuable procedure to minimize the use of more invasive procedures, such as dilation and curettage (D&C) and tissue biopsies.

What should I expect?

TSH is preceded by a baseline vaginal ultrasound examination. The doctor then inserts a catheter into the uterus and injects sterile saline fluid while ultrasound imaging is taking place. Patients may experience cramping during the exam.

How long will it take?

The procedure usually takes about 10 to 20 minutes.

How should I prepare?

You should be prepared to remove all clothing and jewelry in the area to be examined. We will provide you with a gown to wear during the procedure.
It is best to perform sonohysterography one week after menstruation to avoid the risk of infection. At this time in the menstrual cycle, the endometrium is at its thinnest, which is the best time to determine if the endometrium is normal. The timing of the exam may vary, however, depending on the symptoms and their suspected origins. Sonohysterography should not be performed if you are pregnant.

The timing of the procedure is important in patients with fertility problems who are examined during the first 10 days of the menstrual cycle. Patients with active pelvic inflammatory disease (PID) should not undergo TSH until the disease is brought under control.

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Since 2004, Insight Diagnostic Imaging has been helping to improve men’s health, women’s health and children’s health by offering exceptional diagnostic medical services. Our radiology clinics are run by highly respected radiologists using the most advanced medical technology and radiology equipment to generate accurate and quick results. We are proud to be among the most respected and well-known radiology clinics in Toronto and Mississauga.