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Saline infusion sonography (SIS)

What is Saline Infusion Sonography (SIS)?
It is an ultrasound-based procedure where a small amount of fluid is injected into the uterine cavity through a fine tube to outline the uterine cavity.

    What are the common indications for having SIS?
  1. Abnormal uterine bleeding
  2. If the lining of the womb is not seen clearly on routine pelvic ultrasound
  3. Investigation of subfertility
  4. Investigation of recurrent miscarriage
  5. Suspected developmental or acquired uterine abnormalities
  6. Further evaluation of certain abnormalities seen on routine pelvic scan (E.g. In women with changes of lining of the womb due to Tamoxifen therapy for breast cancer)
    What are the advantages of having SIS?
  1. It helps to avoid unnecessary Dilatation and Curettage (D & C) or hysteroscopy in some situations
  2. It helps the patient to avoid the anaesthesia necessary for the procedure  
  3. It avoids hospitalisation.
  4. It is usually helpful in planning removal of uterine polyps or hysteroscopic resection of intra-uterine cavity fibroids.

How is this procedure organised?
A preliminary routine pelvic ultrasound is booked first especially if you haven’t had one done at our clinic within 6 months of having SIS. This is essential as it helps to identify certain situations where SIS may not be feasible or necessary. An appointment for SIS is done following this scan


How long does this procedure take?
It usually takes about 30 minutes to do the procedure.


When is the best time to have SIS done?
It is best done between Day 5- Day 10 of the menstrual cycle taking the first day of your periods as Day 1.

If you are unsure please contact us to discuss the timing of the procedure especially if you have irregular or infrequent periods.


How exactly SIS is done?
A transabdominal scan with or without transvaginal scan may be repeated on the day of your procedure. Bladder is emptied prior to the procedure. Then you are asked to lie on your back with your legs placed in stirrups. A speculum is placed in the vagina and the cervix is cleaned using an antiseptic solution. A fine plastic tube (2mm) is then passed through the cervix and the small balloon at the tip is inflated to keep the catheter in place. Vaginal transducer is introduced again after taking the speculum out. Scan is performed as the saline is injected through the catheter.



Will I need analgesia for the procedure?
You may require a single dose of painkillers such as Panadol following the procedure. Some women find the procedure slightly more uncomfortable than the others.


Will I need to take antibiotics before the procedure?
In general it is not necessary. However it may need to be considered in certain circumstances and you should discuss this with your doctor. The prescription is given to you by your doctor and the antibiotics to be taken 2 hours prior to having SIS.


    Are there any contraindications for having SIS done? You should not have the procedure in the following circumstances.
  • Acute pelvic infection
  • Unexplained pelvic tenderness
  • Suspected pregnancy