Hysterosalpingography

Hysterosalpingography (HSG), also called uterosalpingography, is an X-ray examination of a woman's uterus and fallopian tubes. HSG uses a special form of X-ray called fluoroscopy and a contrast material.

When the uterus and fallopian tubes are filled with the contrast material, radiologists are able to view and assess their functionality.

What Are Some Common Uses of the Procedure?
HSG is primarily used 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 peritoneal cavity.

The procedure can be used to investigate repeated miscarriages that result from congenital abnormalities of the uterus and to determine the presence and severity of these abnormalities, including:

  • Tumor masses
  • Adhesions
  • Uterine fibroids

Hysterosalpingography is also used to evaluate the openness of the fallopian tube and monitor the effects of tubal surgery, including:

  • Blocked fallopian tubes due to infection or scarring
  • Tubal ligation
  • The closure of the fallopian tubes due to a sterilization procedure or a sterilization reversal
  • The re-opening of the fallopian tubes following a sterilization or disease-related blockage

How Should I Prepare?
The hysterosalpingography procedure is best performed one week after menstruation but before ovulation to make certain that you are not pregnant during the exam.

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.

You should inform your physician of any medications you are taking and if you have any allergies, especially to barium or iodinated contrast materials (X-ray dye). Also, inform your doctor about recent illnesses or other medical conditions.

You may 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, dentures, eyeglasses and any metal objects or clothing that might interfere with the X-ray images.

How Does the Procedure Work?
Fluoroscopy uses a continuous or pulsed X-ray beam to create a sequence of images that are sent to a television-like monitor. Fluoroscopy makes it possible for the physician to view internal organs in motion. Still images are also captured and stored electronically on a computer so they are easily accessible and can be compared to current X-ray images for diagnosis and disease management.

How Is the Procedure Performed?
You will be positioned on your back on the exam table, with your knees bent or your feet held up with stirrups. A speculum will be inserted into the vagina; the cervix will be cleaned; and a catheter will be inserted into the cervix. The speculum will then be removed, and you will be carefully situated underneath the fluoroscopy device. The contrast material will then begin to fill the uterine cavity, fallopian tubes and peritoneal cavity through the catheter, and fluoroscopic images will be taken.

In some cases, if certain abnormalities are encountered, you will be asked to rest and wait up to 30 minutes so that a delayed image can be obtained. This delayed image may provide clues to your condition that the original images with contrast material do not. On occasion, an X-ray will be taken the next day to ensure that there is no scarring surrounding the ovaries.

When the procedure is complete, the catheter will be removed and you will be allowed to sit up. You will then be asked to wait until the radiologist or technologist determines that all the necessary images have been obtained.

What Will I Experience During and After the Procedure?
This exam should cause only minor discomfort. There may be temporary discomfort and cramping when the catheter is placed and the contrast material is injected. There may also be slight irritation of the peritoneum, causing generalized lower abdominal pain, but this should also be minimal and temporary. It is normal to experience vaginal spotting for a few days after the examination.

What Are the Benefits and Risks of Hysterosalpingography?
Benefits

  • Minimally invasive procedure that rarely has complications.
  • Relatively short procedure that can provide valuable information on a variety of abnormalities that cause infertility or problems carrying a fetus to term.
  • Can occasionally open fallopian tubes that are blocked, allowing the patient to become pregnant.

Risks

  • In the event of a chronic inflammatory condition, pelvic infection or untreated sexually transmitted disease, be certain to notify the physician or technologist before the procedure to avoid worsening of infection.
  • Women should always inform their physicians or X-ray technologists if there is any possibility that they are pregnant.

Who Interprets the Results and How Do I Get Them?
Our board-certified radiologists will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

Gwinnett Medical Center Imaging has multiple convenient Atlanta-area locations in Lawrenceville, Hamilton Mill and Duluth. If you would like to schedule an appointment, please call 678-312-3444.