Digital Fluoroscopy: Hysterosalpingogram
Digital Fluoroscopy : Preparation Guidelines | Hysterosalpingogram | Frequently Asked Questions
Hysterosalpingogram (HSG) is an x-ray test that shows the size, shape and location of the uterus and fallopian tubes. The procedure helps identify conditions such as fistulas (abnormal tube-like passageways) or polyps (small growths). Most often, however it is performed to determine whether the fallopian tubes, which pass the egg from the ovary to the uterus, are open. This is important when evaluating a patient's ability to become pregnant.
What are some common uses of the procedure?
Your doctor may recommend an x-ray of the uterus and fallopian tubes if he or she suspects infertility. Hysterosalpingography can be used in order to diagnose a blockage of one or both tubes that may prevent a fertilized egg from moving into the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. In addition, this procedure is used to find problems in the uterus, such as an abnormal shape or structure, an injury, polyps, fibroids, adhesions, or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.
It is sometimes performed a few weeks or months after a tubal surgery in order to determine the success of the surgery.
What should I prepare for the procedure?
- This procedure must be performed within 3 to 7 days after the last day of the menstrual cycle but after your period is over and bleeding has stopped. Please refrain from intercourse from the time your period begins until 24 hours after after the exam is performed.
- If you have not had a menstrual cycle in the past month, you must obtain a pregnancy test from your physicians office and present the results with referral at your appointment.
- You can eat and drink normally prior to your exam.
- You can take medicine to relieve or minimize cramps (no aspirin).
- Patients who have experienced an allergic reaction to previous IV contrast studies will be given a Medrol prep.
- This procedure should not be performed if you have an active inflammatory condition. You should notify your physician or technologist if you have a chronic pelvic infection or an untreated sexually transmitted disease at the time of the procedure.
How is the procedure performed?
The patient is positioned on her back on the exam table, with her knees bent and feet in footrests, as you would for a pelvic examination.
A speculum is inserted into the vagina and the catheter (a thin tube) is then inserted into the cervix. A small balloon in the catheter is inflated to hold it in place. The speculum is removed and the patient is carefully situated underneath the fluoroscopy device. The contrast material then begins to fill the uterine cavity through the catheter and fluoroscopic images are taken. The contrast agent is a substance that helps make these organs visible on x-ray films. You may experience some pressure along with some cramping. Its is important to let the technologist, nurse or physician know how you are feeling to help make you as comfortable as possible.
When the procedure is complete, the catheter will be removed and the patient will be allowed to sit up. The contrast agent that remains in the uterus and vagina is discharged due to gravity and any contrast left in the pelvis will be absorbed safely by your body. Only a small amount of contrast is used during the examination, and it has no odor or color.
The hysterosalpingogram is usually completed within 30 minutes.
What risks are associated with this test?
It is common for patients to have a small amount of bleeding from the vagina and some pelvic cramping for a few days after the procedure. If you have heavy bleeding, fever, or increasing pain in the pelvis, you should call your doctor.
Allergic reactions are possible after injection of the iodine-based contrast. Please notify your physician of any allergies you are aware of prior to the procedure.
As with x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from a hysterosalpingogram is too small to be likely to cause any harm. However, since the x-ray exposure is directed right at the pelvis and ovaries, it is very important to be sure you are not pregnant at the time of the test.
What can I expect after having a hysterosalpingogram?
There may be some spotting or light vaginal bleeding for a few days following the procedure. If bleeding increases or persists, call your doctor.
There may be moderate pain or cramping for several hours after the procedure. If the pain increases or persists overnight, call your doctor.
Fever or persistent pain may be an early indication that an infection is developing. These symptoms should be reported to you doctor if they persist more than a few hours.
