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Reasons for Hysterosalpingography
HSG is an X-ray procedure that is used to view the inside of the uterus and fallopian tubes. It checks for scarring or abnormalitues in their size or shape, whcih can lead to infertility and pregnancy problems. HSG also is used ta few months after some sterilization procedures to make sure that the fallopian tubes have been completely blocked.
What to expect
HSG is done in a hospital, clinic, or health care providers office. It is best to have HSG done in the first half (days 1-14) of the menstrual cycle. This timing reduces the chance that you may be pregnant.
HSG is not done in a woman if she
- is pregnant
- has a pelvic infection
- has heavy uterine bleeding atht etime of the procedure
Dr. Greenberg may recommend that you take an over-the-counter pain reliever an hour before the procedure.Discuss this decision with Dr. Greenberg. In some cases, she may prescribe an atibiotic for you to take before HSG. Most people can drive themselves home after having HSG. However, you may not feel well after the procedure, so you may want to make arrangements for someone to drive you home.
During HSG, a contrast medium is placed in the uterus and fallopian tubes. This is a fluid that contains a diye. The dye shows up in contrast to the body structures on an X-ray screen. The dye out-lines their inner size and shape. It also is possible to see how the die moves through the body structures.
The precedure is performed as follows:
- 1. You will be asked to lie on your back with your feet placed as for a pelvic exam. A device called a speculum is inserted into the vagina. It holds the walls of the vagina apart to allow the cervix to be viewed. The cervix is cleaned.
- 2. The end of the cervix may be injected with local anesthesia (pain relief). You may feel a slight pinch or tug as this is done.
- 3. One of two methods may be used to insert the dye. In one method, the cervix is grasped with a device to hold it steady. An instrument called a cannula is then inserted into the cervix. In the other method, a thin plastic tube is passed into the cervical opening. The tube has a small balloon
at the end that is infalted. The balloon keeps the tube in place in the uterus.
- 4. The speculum is removed, and you are placed beneath an X-ray machine.
- 5. The fluid slowly is placed through the cannula or tube into the uterus and fallopian tubes. The fluid may cause cramping. If the tubes are blocked, the fluid will cause them to stretch.
- 6. X-ray images are made as the contrast medium fills the uterus and tubes. You may be asked to change position. If there is no blockage, the fluid will spill slowly out the far ends of the tubes. After it spills out, the fluid is absorbed by the body.
- 7. After the images are made, the cannula or tube is removed.
After the Procedure
After HSG, you can expect to have a sticky vaginal discharge as some of the fluid drains out of the uterus. The fluid may be tinged with blood. A pad can be used for the vaginal discharge. Do not use a tampon. You may also have the following symptoms:
- Slight vaginal bleeding
- Feeling dizzy, faint, or sick to your stomach.
Risks and Complications
Severe problems after an HSG are rare. They include an allergic reaction to the dye, injury to the uterus, or pelvic infection. Call Dr. Greenberg if you have any of these symptoms:
- Foul-smelling vaginal discharge
- Severe abdominal pain or cramping
- Heavy vaginal bleeding
- Fever or chills
HSG is a way to diagnose problems of the uterus and fallopian tubes. The risk of HSG are low but you should know the warning signs of problems. Talk to Dr. Greenberg if you have questions about this procedure.