Hysterosalpingography (HSG) is an examination using X-rays (X-rays) to see the condition of the uterus and the area around it. This examination is generally performed on women who haveinfertility or repeated miscarriages.Histerosalpingography can also called as uterosalpingography.
In the hysterosalpingography procedure, a contrast dye is used in X-ray examination to produce a clearer image. Through these images, problems that occur in the uterus and fallopian tubes can be seen. This examination takes about 15-30 minutes and is performed by a radiologist at a clinic or hospital.
Hysterosalpingography indications
Hysterosalpingography (HSG) is recommended for patients who have:
- infertility. This condition can be caused by blockages in the fallopian tubes, scar tissue in the uterus, an abnormal shape of the uterus, and tumors or uterine polyps.
- fallopian tube blockage, for example due to infection or tubal implant placement (one of the non-surgical methods of permanent contraception)
- Other problems with the uterus, such as abnormal shape, injury, presence of foreign bodies in the uterus, fibroids, and polyps in the uterus. These problems can lead to repeated miscarriages or painful, prolonged periods.
In addition, an HSG can also be performed by a doctor to ensure that the removal of a tubal ligation (tubectomy) operation on a woman who wants to have children again goes smoothly.
Hysterosalpingography Warning
HSG examination can be carried out about 2 to 5 days after menstruation or before ovulation occurs in the following month. This is done to ensure that the patient is not pregnant. In addition, patients also need to consult a doctor first if:
- Having a history of or currently suffering from kidney disease or diabetes, because the use of dyes in this examination is at risk of exacerbating kidney damage.
- Have had bleeding problems or are taking blood-thinning medications.
- Have allergies to certain ingredients, especially ingredients that contain iodine.
- Are suffering from pelvic inflammatory disease or bleeding from the vagina.
Before Hysterosalpingography
In order to avoid pain that the patient may feel during the HSG procedure, the doctor will give pain medication one hour before the procedure. In addition, sedation can also be given, especially if the patient feels nervous about this procedure. Antibiotics can be given before or after the HSG to avoid infection.
The doctor will also ask the patient not to wear jewelry or any metallic object because it can interfere with the work of the scanner.
Hysterosalpingography Procedure
When performing the HSG, the patient is asked to lie down on a special examination chair with the knees bent and the legs spread apart. After that, an instrument called a speculum or cocor duck is inserted into the vagina to open the vaginal canal so that the inside of the vagina and cervix can be seen. At this stage, the patient will feel a little uncomfortable. Next, the cervix is cleaned with a special soap and local anesthesia can also be given to make the patient feel more comfortable.
In the next stage, a small hose (cannula) or a flexible catheter is inserted into the cervix to reach the uterus. Contrast dye is then inserted into the tube so that it can flow down the fallopian tube and then into the abdominal cavity, where it will be absorbed by the body. This action is often called hydrotubation.
If the fallopian tubes are blocked, the dye cannot flow. The patient may feel slight pain and cramping during the process, especially as the dye flows through the fallopian tubes.
Subsequently, an X-ray was performed. The patient may be asked to change several positions so that the examination can produce images from various angles. After the X-ray examination, a small tube was removed and the patient was allowed to go home with a prescription in the form of painkillers and antibiotics.
After Hysterosalpingography
After HSG, patients usually still feel cramps like menstrual pain and experience light bleeding from the vagina for a few days. This is a natural reaction that will subside on its own. Doctors will advise patients not to use tampons to prevent infection.
Symptoms that indicate the occurrence of infection after examination with HSG and need medical attention are as follows:
- Throw up.
- Fever.
- Smelly discharge from the vagina.
- Abdominal pain and severe cramps.
- Dizziness.
- Heavy bleeding or bleeding that lasts more than 3 or 4 days.
Hysterosalpingography Complications
Complications that can arise after HSG are:
- Allergic reaction to dyes.
- Infections of the pelvic bones (pelvis), such as endometritis and salpingitis. The risk for developing these two conditions is even greater if the patient has a previous history of hip bone infection.
- Pulmonary embolism is caused by the use of an oil-based dye that leaks into the blood, blocking blood flow to the lungs.
- Tissue or cell damage from X-ray radiation.