Dr. Steven R. Goldstein, Saline Infusion Sonohysterograms for Abnormal Uterine Bleeding Dr Steven R Goldstein is an obgyn in Manhattan, regarded as one of the world’s most highly regarded individuals in the field of gynecologic ultrasound and a former Director of Gynecologic ultrasound at NYU Langone Medical Center in New York City. Women who experience abnormal uterine bleeding or are suspected to have some abnormalities are sometimes told to have a biopsy or Dilation and Curettage (D&C) procedures. Both are painful procedures. Dr Goldstein instead uses painless Saline Infusion Sonohysterograms as a first means of diagnosis.
Vaginal sonography gives us an image magnification as if we were doing ultrasound through a low powered microscope. For instance, we can see a heartbeat in a 3 mm embryo. So vaginal sonograms today give us an image magnification we’ve never had before. In gynecology, sometimes we cannot see the lining of the uterus very well. This gave rise to a technique called saline infusion sonohysterogram (SIS). A tiny catheter, the size of a swizzle stick, goes into the cervix a couple of inches tops, inject about a tablespoon of sterile saline. Dr Goldstein, a Gynecologist in Manhattan, developed a tiny catheter for these purposes.
The injection of a tablespoon of water into the uterus via catheter pushes the front and back walls of the uterus apart and enables us to see the uterine lining with microscopic precision. Why is this important? If we can now see that there is no tissue there, the patient doesn’t need a biopsy, a dilation and curettage (D&C) or any further workup if she is having an abnormality. However, if we see something that globally involves the entire cavity, then a biopsy can be done. If we see something that is in one area only, such as a polyp or fibroid, then the patient can have a D&C or hysteroscopy under anesthesia so we can be sure to get the area that’s involved. So if you have abnormal bleeding and someone says to you to have a biopsy, ask them for a saline infusion sonohysterogram (SIS) first. Dr Steven R. Goldstein is a leading Obgyn in Manhattan and former Director of Gynecologic Ultrasound at NYU Langone Medical center who advocates for the use of Transvaginal Ultrasounds or Saline Infusion Sonohysterograms over painful exploratory surgeries. You may schedule a consultation with him at his Manhattan office where these procedures are performed in a short period right in the office. **********************************EOD*****************************************