Hysterosalpingography Health Article

Definition

Hysterosalpingography is a procedure where x rays are taken of a woman's reproductive anatomy after a contrast dye is injected into the cervix. Hystero means uterus and salpingo means tubes, so hysterosalpingography literally means to take pictures of the uterus and fallopian tubes. This procedure may also be called HSG or hysterography.

Purpose

Hysterosalpingography is used to determine if the fallopian tubes are open, or if there are any apparent abnormalities or defects in the uterus. It can be used to detect tumors, scar tissue, or tears in the lining of the uterus. This procedure is often used to help in diagnosing any physical abnormalities causing infertility in women. The fallopian tubes are the location where an egg from the ovary joins with sperm to produce a fertilized ovum. If the fallopian tubes are blocked or deformed, the egg may not be able to descend or the sperm may be blocked from moving up to meet the egg. Up to 30% of all cases of infertility are due to damaged or blocked fallopian tubes.

Precautions

This procedure should not be done on women who suspect they might be pregnant or who may have a pelvic infection. The exam is usually timed within a few days after a period to minimize the chance of performing the procedure while the patient is pregnant. If a woman has a history of heart abnormalities, she should consult with her doctor prior to the exam. Women who have had an allergic reaction to the contrast dye used in previous xray procedures should inform their doctor.

Description

As with other types of pelvic examinations, the woman will lie on her back on an examination table with her legs sometimes raised in stirrups. The x-ray equipment is placed above the abdomen.

A speculum is inserted into the vagina by the radiologist. The cervix is numbed with a local anesthetic such as Xylocaine 1%, and sometimes an instrument called a tenaculum, is gently clamped onto the cervix to hold it steady. This is mostly painless, although the patient will feel some pressure from the clamp. A catheter (a thin tube) is inserted into the uterus through the cervix (the opening to the uterus). A tiny balloon in the catheter is

inflated to hold it in place. A liquid water-based or oilbased dye is then injected through the catheter into the uterus. As the contrast spills into and out of the fallopian tubes, some cramping, pain, and spasms usually occur. The patient might also feel a burning sensation in her pelvic cavity.

As the contract spreads through the reproductive tract, the doctor will watch for blockages or abnormalities on an x-ray monitor. Several x rays will also be taken. The procedure takes approximately 15–30 minutes. The x rays will be developed while the patient waits, but the final reading and interpretation of the x rays by a radiologist (a doctor who specializes in x rays) may not be available for a few days. Typically, the radiologist can give the patient their impression, as they watch the progress of the contrast.

Interestingly, sometimes the hysterosalpingography procedure itself can be considered a treatment. The contrast used can sometimes open up small blockages in the fallopian tubes. This happens due to the pressure created in the injection of the contrast, and it is not uncommon for the patient to become pregnant in the month or two after the exam. The need for additional test procedures or surgical treatments to deal with infertility should be discussed with the doctor.