Hysterosalpingography (HSG)

Hysterosalpingography (HSG) is radiological examination to help the study of uterine cavity and fallopian tubes by the injection of contrast media through vagina.

Indication Of Hysterosalpingography (HSG).

— infertility.

— Recurrent abortions.

— Congenital uterine abnormalities.

— Fibroids, malignant and polyps etc in uterine cavity.

— Bleeding from the uterine cavity.

— Blockage of fallopian tube.

— Tuberculosis.

— To rule out any abnormalities like Unicornuate, bicornuate and septate.

 Contraindications Of Hysterosalpingography (HSG).

— Pregnancy.

— Recent surgery.

— infection of vagina.

— Hypersensitivity to contrast media.

— Recent dilation and curettage or abortion.

— Immediately post menstruation.

Equipment.

— Fluoroscopy unit or x-ray units.

— Speculum

— Vulsellum or tenaculum forceps.

— Foley’s catheter.

— Syringe 20ml.

— Antiseptic solution.

— Anesthesia local.

 Contrast media.

— HOCM or LOCM contrast media required ( Urograffin 60% ) at 10- 20 ml.

Patient Preparation For Hysterosalpingography (HSG) 

— The patient must be NPO for 4 hrs.

— The patient should be advise to avoid the intercourse between the appointment and the time of examination day.

— Before the examination the 10 day rules must be applied.

— ask to the patient should be emptied bladder before the examination.

 Procedure/ Technique For Hysterosalpingography (HSG)

— When the patient in radiology department, describe the whole Procedure.

— Ask to the patient remove all clothes before the examination and wear hospital gown.

— The patient in lithotomy position at the edge of Fluoroscopy table or x-ray table.

— The vagina must be cleaned with the help of antiseptic solution.

— A speculum is introduced into vagina and the anterior lip of the cervix is held with tenaculum.

— The Cannula is inserted into cervical canal under direct vision.

— After then speculum is then removed and the patient carefully move upside of table.

— The contrast loaded in 10-20ml syringe at not any air bubbles present in syringe.

— Then 2-3 ml contrast is injected to outline the uterine cavity at under the fluoroscopy guidance.

— Then take film.

 Filming 

a) plain film taken before the injected of contrast media.

b) 2nd film taken for uterine ( fallopian ) tube being to fill.

c) When the peritoneal spill has occurred with all instrument removed.

Complications.

— Pain during procedure.

— Infection

— Bleeding.

— Transient nausea.

— Vomiting

— Headache

— Raptured the endometrium.

Aftercare.

— It must be ensured the patient in no serious discomfort before leaving the department.

— Patient must be take for few hrs for observation in gynecologist.

— If the patient in heavy pain then call the doctor.

— The patient must be advise that may occur bleeding in 1-2 days from your vagina.

FAQs.

Q. Is HSG test painful?

Yes, HSG test is painful.

Q. Is HSG helpful for pregnancy?

Yes HSG is helpful for pregnancy because it increased 30% pregnancy rate for the first 3 months after HSG.

Q. What is HSG test used for?

To view the inside of uterus and fallopian tubes.

Q. What should avoid HSG?

HSG patient must be also abstain from sexual intercourse from day one of their menstrual period until 24 hrs after the procedure has been completed.

Q. Can sperm survive HSG?

Yes it is possible for the eggs and sperm to survive after an HSG.

Q. What is the best time to do HSG test?

The best time to do HSG test is usually done between 5 – 10 days of cycle.

Q. Is HSG test compulsory?

Yes HSG test is compulsory because if patient have been trying to get pregnant for quite some time and have found no success yet then a HSG is compulsory.

Q. Can HSG damage fallopian tube?

There is a small chance of damaging or puncturing the uterus or fallopian tubes during the test.

Q. Does it bleed after HSG test?

Yes, vaginal spotting is compulsory occurs for 1 to 2 days after HSG.

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Fundamentals of special radiographic procedures

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