Hysterosalpingography, or HSG is an xray examination of a woman'suterus and fallopian tubes that using real time imaging called fluoroscopy and a liquid contrast material (X ray dye). The Hysterosalpinogram is performed by a Radiologist (doctor specialising in medical diagnosis using X-rays) and a Medical Radiation Technologist (expert in the use of x-ray equipment).
Hysterosalpingography is most commonly performed to examine women who have difficulty becoming pregnant by allowing the radiologist to evaluate the shape and structure of the uterus, the openness of the fallopian tubes, and any scarring within the uterine cavity. This procedure can also be used to investigate repeated miscarriages that result from congenital or acquired abnormalities of the uterus.
Anatomy of the female reproductive system
The Hysterosalpingography procedure is best performed on day 8 or day 9 after menstruation, doing the exam at this time ensures you are not pregnant.
Prior to the procedure you may eat and drink normally and continue to take any prescribed medications.
You will be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry and any metal objects that might interfere with the x-ray images.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
You will be asked to empty your bladder and then lie on your back on an examination table with your legs in a frog like position. The Radiologist will put a smooth, curved speculum into the vagina. The speculum gently parts the vaginal walls, allowing the inside of the vagina and the cervix to be visible. The cervix is cleaned with a special soap and a soft thin cannula is then put through the cervix into the uterus. The dye is then slowly put through the cannula and X-ray pictures are taken as the uterus fills. The X-ray pictures are shown on a TV monitor during the test. The examination table may be tilted or you may be asked to change position.
If the fallopian tubes are open, the dye will flow through them and spill out; this dye spillage will be naturally absorbed by the body. If a fallopian tube is blocked, the dye will not pass through.
After the test, the cannula and speculum are removed. This test usually takes 15 to 30 minutes.
The x-ray pictures can usually be reviewed as soon as the procedure is done and the radiologist may be able to tell you the result immediately, but in some cases he/she may need to study the images
A report will then be sent to your referrer.
You may have some discomfort when the speculum is inserted into the vagina. This is similar to a smear test.
Some women have cramps during or after the test, similar to period pains.
Complications from a Hysterosalpingography are rare. Possible risks include:
After the test, you may continue to have cramps similar to those experienced during a menstrual cycle. You may also experience vaginal discharge or slight vaginal bleeding. A pad will be provided on completion of the examination.
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