Anomalies in the structure of the uterus often affect the fertility and ability to conceive a woman. Hysterosalpingography of the fallopian tubes, uterus examines the female reproductive organs, helps the gynecologist to learn about the existence of pathologies.

What it is

Hysterosalpingography, abbreviated as HSG, is an x-ray and ultrasound procedure that evaluates the condition of the uterine cavity and fallopian tubes.

This non-invasive medical test transmits a video image of an organ. It is called in medicine ultrasonic hysterosalpingography, uterosalpingography or fluoroscopy.

The x-ray technique uses a water-soluble contrast material to produce internal images of the uterus, which are then interpreted by a radiologist.

Indications for the procedure

The procedure is performed when a woman has been diagnosed with infertility or difficulty conceiving. This diagnosis determines:

shape, structure of the uterus;

openness of the fallopian tubes;

the presence, absence of scars in the uterine cavity and peritoneum;

causes of miscarriages, missed pregnancy;

congenital anomalies.

Diagnostics reveals adhesions, neoplasms and fibroids. Ultrasound hysterosalpingography is sometimes used to evaluate the effects of tubal surgery:

blockage of the fallopian tube due to scarring or infection

tubal ligation

closures of the fallopian tubes during sterilization;

reopening of the fallopian tubes blocked due to disease or sterilization.

How is it carried out

During the procedure, a fluoroscopic hysterosalpingography catheter transmits a continuous x-ray beam to create moving images. They are recorded by the detector and then projected onto a monitor.

The contrast material used for the procedure is inserted into the cavity of the female reproductive organ. Therefore, if a dark spot is found in the uterus on the HSG, do not be afraid.

The image contrast is then electronically changed to white, which helps the radiologist see the movement of internal organs. The images are saved as digital files on a computer.

What equipment is used

For the procedure are used:

radiographic table;

one or two x-ray tubes and an ultrasonic detector suspended above the x-ray table;

• expander.

Training

Hysterosalpingography is usually performed one week after menstruation but before ovulation. This eliminates any chance of pregnancy.

The subject will be given over-the-counter medication or a mild sedative to relieve discomfort or pain during the HSG.

The preparation contains 600-800 mg of ibuprofen. The medicine is taken approximately 1-2 hours before the diagnosis. If a woman is allergic to ibuprofen, Aspirin, or similar drugs, the doctor will give Paracetamol. In some cases, a doctor will prescribe an antibiotic.

The patient will be asked to remove jewelry, glasses, or dental equipment to avoid the negative effect of metals on x-rays.

Hysterosalpingography is used as an examination that identifies possible causes of female infertility. For the procedure, you need to consult with your doctor.

Have you had a hysterosalpingogram? Tell us about the study in the comments. Share the article with your friends on social networks.

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Possible complications after hysterosalpingography

What is hysterosalpingography?

Hysterosalpingography (HSG)

What is hysterosalpingography? HSG is such a research method that allows you to carefully examine the inner surface of the uterus and fallopian tubes. It gives maximum information in case of congenital or acquired diseases, which are accompanied by a change in the structure of these organs. For this, a series of x-rays is taken.

HSG is prescribed for suspected of the following diseases and pathologies:

• congenital anomalies in the development of internal female genital organs;
• violation of the patency of the pipes after inflammatory processes, an abortion;
• benign and malignant neoplasms;
• for diagnosing tubal infertility in a patient after exclusion of hormonal causes (including before IVF);
• specific inflammatory processes (tuberculosis, syphilis);
• isthmic-cervical insufficiency;
• a history of ectopic pregnancies;
• spontaneous abortion at any stage of pregnancy;
• pathology of previous births.

Usually, HSG X-ray or hysteroscopy is performed in patients who have already undergone a complex preliminary examination (OAC, OAM, blood biochemical parameters, ultrasound of the pelvic cavity organs).

Test contraindications

HSG during pregnancy in gynecology is strictly prohibited. There is strong evidence of the negative effects of contrast, as well as x-ray radiation on the fetus. Therefore, the only approved way to diagnose pathology during this physiological state remains a standard ultrasound of the fallopian tubes. Also, HSG should not be performed during lactation.

Also, an absolute contraindication to the study is the presence of any allergic reaction to drugs that are used as a contrast. Many guidelines also strongly recommend that a hypersensitivity test be performed before initiating HSG.

Research is also prohibited under a number of conditions:

• inflammatory processes of the genital organs of the patient;
• the presence of functional insufficiency of the kidneys or liver;
• decompensated cardiovascular diseases (ischemic disease, congenital malformations);
• any form of uterine bleeding;
• hormonal imbalances associated with thyroid disease;
• increased tendency to form blood clots (thrombophilia, thrombophlebitis).

Relative contraindications for HSG of the fallopian tubes include inflammatory changes in general blood tests (leukocytosis, increased ESR, an increase in the number of neutrophils) and urine, bacteriological examination of a vaginal smear.

Ultrasonic hysterosalpingoscopy (USGSS)

Ultrasonic hysterosalpingoscopy is actually a transvaginal ultrasound examination of the pelvic organs with the introduction of glucose, furacilin or saline into the lumen of the uterus. Ultrasound hysteroscopy provides a dynamic image of the spread of fluid in the uterine cavity and fallopian tubes.

This method has a number of advantages over HSG. Ultrasonic hysterosalpingoscopy does not require the introduction of contrast, which eliminates the possibility of allergic reactions, and also reduces the list of contraindications. Also, this method does not expose the patient's body to X-ray exposure. With ECHO HSG of the fallopian tubes, complaints of pain and a feeling of heaviness are less common.

Ultrasound hysterosalpingography, with such a large number of advantages, also has its disadvantages. It visualizes the organ cavity worse, which reduces the information content of diagnostics. The quality of the results depends on the qualifications of the diagnostician, which, if there are errors, has negative consequences in the future.

Preparation for the study

Many patients are concerned about the question of how to prepare for the HSG and USGSS so that the results of the study are as informative as possible. After the appointment of the procedure, all of them are carefully informed about this by the attending physician.

Preparation for HSG of the fallopian tubes and hysterosalpingoscopy consists of several important steps. First, the gynecologist needs to conduct a general examination of the state of the main functional systems of the body. Additionally, the patient is tested for some common infectious diseases (AIDS, syphilis, gonorrhea). On the evening of the day before the study, it is also recommended to conduct a cleansing enema to remove stool from the intestines.

The study is carried out on the 5-10th day of the menstrual cycle. This allows, on the one hand, to almost completely exclude pregnancy in the patient, and on the other hand, a thinner endometrium contributes to a lesser intensity of discomfort during the procedure and better visualization of the organs.

On the day of the HSG or ultrasound for patency of the fallopian tubes, it is necessary to thoroughly toilet the patient's external genital organs, as well as shave her pubic hair, as they may interfere with the study.

The HSG procedure in gynecology involves emptying the patient's bladder immediately before the start of the study. It is also necessary to remove all metal jewelry and clothing in the genital area and pelvis. Hysteroscopy, on the contrary, requires the patient to have a full bladder before the examination.

Research methodology

X-ray examination of pipes for patency is carried out in a special room. The patient takes a seat on a standard table for gynecological interventions. Both the HSG and the ultrasound of the patency of the fallopian tubes begin with an external examination by a specialist of the woman's external genitalia, vagina and cervix using a gynecological speculum. After that, an antiseptic treatment is carried out and a catheter is inserted into the cervical canal, through which a contrast agent is injected.

The first picture is taken after the introduction of 2-3 ml of contrast. After a short period of time, a second portion of the substance is supplied, which contributes to its penetration into the lumen of the fallopian tubes. It is at this moment that the second picture is taken. With normal tubal patency, some amount of contrast enters the abdominal cavity. If necessary, a third shot is taken after 20-30 minutes.

The use of drugs during the procedure

HSG is considered an almost painless procedure, as is ultrasonic hysterosalpingoscopy. Therefore, anesthesia is used only for severe pain in a very small proportion of patients.

In some clinics, antispasmodics (drotaverine, papaverine) are additionally administered before the study, which allows you to relax the cervix and avoid problems with the introduction of the catheter into the uterine cavity.

Side effects during HSG

Checking the patency of the fallopian tubes with the help of the introduction of contrast may be accompanied by the development of side effects, although in general the procedure is considered absolutely safe. About a third of patients note the presence of discomfort in the abdomen, which sometimes turns into pulling or aching pain.

The most dangerous complication of the procedure is the development of local and general allergic reactions of varying severity. Cases of anaphylactic shock with systemic hemodynamic disturbances are described. Therefore, this procedure is approached by medical personnel with special attention and caution.

If the research methodology is violated, traumatic damage to the uterine mucosa by the catheter is not excluded, which is clinically manifested by bleeding from the vagina.

Research results

Hysteroscopy allows for a thorough examination of the uterine cavity and fallopian (fallopian) tubes. The radiologist receives high-quality images of the anatomical structure of the internal genital organs of the patient. They can be used to visualize signs of congenital malformations, the consequences of inflammatory processes, the presence of tumors. It is impossible to establish the type of oncological process with hysterosalpingography, therefore, if it is detected, then a biopsy with a cytological examination is usually performed. Ultrasonic hysterosalpingoscopy also provides information about the condition of the walls of the uterus, the presence of pathology in the myometrium.

Hysterosalpingography remains the leading and simple method for diagnosing the causes of tubal infertility and anomalies in the development of internal genital organs in women. Along with it, ultrasonic hysteroscopy is performed, which is characterized by less information content and high subjectivity of the results, but has fewer contraindications.

A transcript of the results is usually sent to the attending gynecologist or issued to the patient immediately after the study. They not only help to assess the patency of the fallopian tubes by ultrasound, but also determine the further tactics of diagnosing and treating the patient.

How the study is done

Ultrasonic hysterosalpingography in the Yunona clinic is performed on an outpatient basis and takes about 20-30 minutes in duration.

The patient is placed in a gynecological chair. After treating the skin and mucous membranes with an antiseptic solution, a sterile saline solution is introduced into the uterine cavity through a special catheter, from where it enters the lumen of the fallopian tubes. With the help of ultrasonic waves, the process of filling the cavities is controlled and their shape and patency are assessed.

Preparation for ultrasound hysterosalpingography consists in a preliminary examination aimed at identifying infectious and inflammatory processes. The doctor will provide you with a complete list of necessary tests. The optimal time for the study is the first half of the menstrual cycle. The procedure usually does not cause significant discomfort to the patient and does not require anesthesia.

Benefits of US-HSG at the Yunona Clinic

The specialists of our medical center have extensive experience in performing ultrasound hysterosalpingography. Over the years of using this diagnostic technique, we have improved it and were able to achieve maximum information content of the study and safety for patients.

• Before the start of the study, the doctor of the clinic explains in detail the features of the upcoming procedure and answers all questions of interest.
• Thanks to the use of disposable catheters for the introduction of fluid, modern methods of cavitation of solutions and sterilization of sensors, the risk of complications is virtually eliminated.
• Planning the optimal timing of the study and the introduction of mild antispasmodics can increase the accuracy of the information received.
• The cooperation of specialists in ultrasound diagnostics and the attending gynecologists ensures the correct interpretation of the results of the study.

Ultrasonic hysterosalpingography in the medical center "Yunona" is a high information content of the study and safety for the patient.

Advantages of ultrasound over other methods

• Security. Ultrasound, unlike x-rays, does not harm the body. The saline solution used during the diagnosis is also harmless.
• Painlessness. The study does not cause any pain.
• Fast result. Ultrasound examination of the patency of the fallopian tubes does not require hospitalization, it takes no more than an hour (along with the processing of the results and entering them into the medical record).
• Affordable price. Ultrasound is cheaper than many methods for checking the patency of the fallopian tubes: MRI, radiography, etc.

Indications for ultrasound patency of the fallopian tubes

• Irregular menstrual cycle.
• Suspicion of infertility (unsuccessful attempts to conceive a child within a year).
• Frequent inflammation of the genital organs.
• Pain in the lower abdomen.
• Transferred venereal diseases.
• Preparation for artificial insemination.

Preparation for the procedure

The most accurate results can be obtained when performing an ultrasound scan from the 6th to the 12th day of the menstrual cycle, when the cervix is ​​​​maximally expanded, and the endometrium (the inner lining of the uterus) has a small thickness. Before the procedure, the doctor may prescribe a number of tests, including a smear for microflora (not included in the cost of ultrasound of the patency of the fallopian tubes). If the study is performed transvaginally (the probe is inserted into the vagina), no additional preparation is needed, it is only necessary to empty the bladder. If the procedure is performed through the abdominal wall, products that cause increased gas formation should be discarded 2–3 days before the ultrasound, and a liter of non-carbonated water should be drunk an hour before the ultrasound. Also, the doctor may recommend taking an antispasmodic 20 minutes before the procedure.

How is the procedure carried out

If the patient is healthy, the procedure is comfortable. In the presence of adhesions in the pipes, unpleasant sensations are possible, comparable in strength to pulling pains during menstruation.

1. The patient is located in the gynecological chair.

2. The doctor inserts a thin catheter into the uterine cavity, through which a sterile saline solution warmed up to 37 ̊С slowly begins to flow.

3. The doctor observes the process of filling the uterine cavity and fallopian tubes with a solution using ultrasound.

4. At the end of the study, the catheter is removed from the uterus, the sensors are removed. As a rule, the whole process takes 20-30 minutes.

After conducting a study of the patency of the fallopian tubes during the day, there may be slight spotting from the genital tract. If bleeding or pain occurs, you should immediately consult a doctor.

Possible results

If the injected fluid freely enters the fallopian tubes and abdominal cavity, then the patency is normal. If the solution accumulates in the tube and does not leave it, this may signal the presence of a pathological process (adhesions, anomalies in the development of organs, polyps, myomatous nodes, etc.). In some cases, checking the patency of the fallopian tubes on ultrasound can increase the elasticity of non-rough adhesions. Due to this, the condition of the organ can improve without additional treatment. If necessary, the doctor draws up a therapy regimen to restore the patency of the fallopian tubes. You can also get treatment in our medical center.

You can learn about the need for the procedure, individual contraindications and the nuances of preparing for an ultrasound of the patency of the fallopian tubes during a personal consultation with a doctor. Make an appointment using the online form on the website or by phone.

Indications for hysterosalpingography

This type of diagnosis is used primarily to determine the causes of infertility. It is with this diagnosis that most often they turn to specialists for HSG. The procedure is also carried out:

• after operations on the uterus, as well as in the detection of pathologies to monitor their condition;
• with anomalies in the development of the genital organs;
• with suspicion of isthmic-cervical insufficiency;
• for the diagnosis of tuberculosis of the genital organs.

This procedure allows you to determine the patency of the fallopian tubes, as well as to see the outlines of the internal organs. This makes it possible to assess the reproductive function and identify possible causes of infertility, prescribe effective methods of their treatment.

Training

HSG of the fallopian tubes should be carried out in the first half of the cycle. During this period, the state of the endometrium is most favorable for diagnosis. It is also necessary to pass tests:

• blood;
• urine;
• smear.

In the presence of infections, you should undergo a course of treatment, since during the hysterosalpingography, infection of the internal organs can occur. You should also refrain from sexual activity 2 days before the diagnosis.

How is the procedure carried out

The preparatory stage for the HSG of the fallopian tubes is the examination and analysis, after which the doctor prescribes treatment or performs the procedure. Hysterosalpingography occurs as follows:

• treatment of the cervix with an antiseptic;
• placement of a special catheter in the cervical canal;
• introduction of a special contrast agent, smooth filling of internal organs;
• x-ray of the fallopian tubes and uterine cavity.

Based on the images obtained, the doctor makes a conclusion. The contrast agent injected into the uterine cavity is safe and does not cause allergies. It allows you to see the outlines of the internal organs and detect possible obstacles in the way of the egg, such as adhesions, polyps and other formations.

HSG of the fallopian tubes and uterine cavity takes an average of 40 minutes. At the same time, a significant part of the time is required for the release of fluid into the abdominal cavity. In some cases, discomfort may occur, as in the first days of menstruation. There may be some bleeding and spotting after the procedure.

Contraindications

HSG of the fallopian tubes is not carried out in the following cases:

• with inflammatory processes in the genitals;
• during pregnancy;
• with severe intrauterine bleeding.

There are also some other indications for which the procedure is not recommended. These include, for example, kidney or heart failure. Therefore, a consultation and examination of a gynecologist is required before conducting a HSG of the fallopian tubes, and it is also necessary to pass tests for infectious and some other diseases.

Advantages of this technique

Hysterosalpingography is a modern and effective technique that allows you to monitor the condition of the uterus and detect pathologies with high accuracy. Among its advantages are:

• painlessness, in some cases, the use of local anesthesia is acceptable;
• HSG is a minimally invasive method that does not injure tissues;
• low likelihood of complications;
• prompt and accurate result, which makes it possible to draw a conclusion about the causes of infertility and miscarriage.

Turning to the "City Clinical Hospital No. 13" in the Avtozavodsky district of Nizhny Novgorod, you can count on the competent assistance of doctors and attention to your women's health. Our clinic employs experienced specialists who will provide a reliable result of the HSG of the fallopian tubes and will be able to prescribe the appropriate treatment. We offer low prices for hysterosalpingography, you can familiarize yourself with the procedure for providing paid services on the website. We cooperate with leading insurance companies, provide services on the basis of compulsory and voluntary medical insurance policies in accordance with the procedure established by law.

Advantages of undergoing the procedure in our medical center

• In our medical center, you can get advice from an experienced doctor, as well as undergo the examinations that he will prescribe for you. This saves you a lot of time!
• More than 70% of our doctors are specialists of the highest medical categories. They have extensive experience and regularly improve their skills.

Indications:

• Suspicion of infertility;
• Obstruction of the fallopian tubes;
• Malformations in the development of the uterus and appendages;
• Polyps.

Contraindications:

• Severe somatic diseases;
• Bloody discharge from the genital tract;
• Pregnancy;
• Lactation.

Preparation for the examination

HSG requires preparation from the patient. First of all, it is necessary to abandon the use of vaginal therapeutic agents. A week before the examination, you should switch to a sparing diet, which consists in the exclusion of gas-forming products. Two days BEFORE and two days AFTER hysterosalpingography, abstinence from sexual intercourse is required.

Doctors of our clinic

Borisova Natalya Vladimirovna

Obstetrician-gynecologist, Gynecologist

Balanda Marina Vadimovna

Gynecologist, Mammologist, Oncologist

Chigrinets Valentina Alexandrovna

Obstetrician-gynecologist, doctor of the highest category

QUESTION ANSWER

Which is better: x-ray or ultrasound?

• Ultrasound and X-ray HSG are equivalent in terms of informativeness and methodology. The difference lies in the contrast agents used, which are injected through a probe into the uterine cavity and fallopian tubes. In the first case, a hypoallergenic solution is used. In the second, a preliminary test for sensitivity to iodine is required. Also, after RG-HSG, it is recommended to refrain from pregnancy for 1 menstrual cycle.

The cost of treatment in our medical center

If you are interested in the cost of this procedure, you can familiarize yourself with the price list below.

Gynecologist

Name of service:

Service cost:

Appointment with a gynecologist of the highest category primary	1 590 rub.
Repeated appointment with a gynecologist of the highest category	1 190 rub.
Primary gynecologist appointment	1 290 rub.
Repeated appointment with a gynecologist	1 000 rub.
Appointment with a gynecologist without a gynecological examination	990 rub.
Biopsy of the cervix	3 100 rub.
Biopsy of the cervix and scraping from the cervical canal	4 090 rub.
Bougienage of the cervical canal	1 590 rub.
Introduction (removal) of the intrauterine device (without the cost of examination and IUD).	1 270 rub.
Gynecological massage - 1 session	620 rub.
Diathermoexcision, diathermoconization of the cervix with biopsy	2 770 rub.
Treatment of the cervix after manipulation	250 rub.
Polypectomy (gynecology)	1 500 rub.
Radio wave coagulation of cervical erosion	4 890 rub.
Radiosurgical removal of formations on the skin (mucous membranes) 1-10pcs	1 800 rub.
Radiosurgical removal of formations on the skin (mucous membranes) 1-3 pcs	1 400 rub.
Radiosurgical removal of formations on the skin (mucous membranes) 1-6 pcs	1 590 rub.
Extended colposcopy with samples	940 rub.
Scraping from the cervical canal	3 000 rub.
Removal of a foreign body from the vagina	850 rub.
Removal of a cyst of the cervix by radiosurgery (1 unit)	1 590 rub.

Book an appointment with a gynecologist

What is hysterosalpingography

What is GSG? Hysterosalpingography, or HSG, in gynecology is a medical examination that allows you to check the fallopian tubes for patency and examine the uterine cavity.

There are two main ways to do it:

• HSG with X-ray;
• Ultrasound (ultrasound) HSG, hydrosonography or ultrasound hysterosalpingography.

How to prepare for the study

Preparation for HSG using X-ray is carried out as follows.

To fully prepare for the diagnosis, it is necessary to give up sexual intercourse for a while, as well as undergo research:

• general blood and urine tests for HSG;
• testing for HIV AIDS, hepatitis, and syphilis;
• assessment of the purity of the vagina.

Before the examination, a woman should take an enema and thoroughly clean her intestines. To do this, you can use the Fortrans tool.

Before scanning, you need to carry out all hygiene procedures, including the removal of hairline. Douching is not necessary.

During the examination, the stomach must be absolutely clean. If the HSG was scheduled for the morning, then breakfast should be discarded.

Preparation for hysterosalpingography includes one to three glasses of water, but do not empty the bladder. At the same time, many medical specialists recommend drinking a glass of non-carbonated water two to three hours before the examination and immediately urinate.

Indications and contraindications

The main indication for HSG of the fallopian tubes is the inability to conceive a child for a long time. In addition, if a woman has a history of miscarriages, the doctor will automatically refer her to the procedure.

If there is a suspicion of the presence of tumors, polyps, or the appearance of dark brown discharge, then specialists also prescribe this form of research.

When should hysterosalpingorophy not be performed?

There are contraindications to HSG of the fallopian tubes:

• inflammation of the uterus and its appendages;
• if the purity of the vagina is rated at the third or fourth degree;
• pregnancy, since with x-rays there is a possibility of irradiation of the fetus. This contraindication does not apply to Echo-HSG;
• suspected ectopic pregnancy;
• diseases of the cardiovascular system;
• allergy to the components of the solution that is used during the procedure.

How is a fallopian tube x-ray done?

The HSG procedure, which includes an x-ray of the uterus and both fallopian tubes, proceeds as follows.

To anesthetize the genitals, about half an hour before the procedure itself, the patient is given drugs such as no-shpa, ketanov or the like to relieve muscle spasm and reduce the intensity of pain.

A special table is equipped for the HSG. Most often, various gynecological operations are performed on them. Preparatory procedures take longer than the study itself, which lasts about 15-20 minutes.

After that, the patient is placed on it so that her pelvic bone is located on the edge of the table. The legs are in a bent position and are mounted on the holder. The patient undergoes a complete disinfection of the genitals to prevent the penetration of harmful microbes and bacteria.

Further, with the help of gynecological instruments, the cervix is ​​exposed. After that, it is necessary to supply fluid through the vagina and cervix directly into the uterus and narrow tube channels. To do this, the doctor uses a thin tube with contrast, which is connected to a syringe. The basis of the injected solution is a contrast agent, for example, Ultravist, Verografin. Its key feature is the presence of iodine in the composition.

A contrast solution with a volume of 2-3 ml is introduced, after which the first picture is taken. Thus, the doctor examines the uterine cavity. To diagnose the patency of the fallopian tubes, a solution of 3-4 ml is used. Only after that do the second picture. If necessary, the diagnostician may decide to take a third x-ray. It is carried out half an hour after the main examination.

Once the procedure is completed, the patient is placed on the bed, where she must rest for about an hour.

What are the results of hysterosalpingography normal

The doctor draws his conclusions on the basis of the obtained images, providing the patient with a complete transcript. If everything is in order, then they will show the uterus in the shape of a triangle, which has two fallopian tubes, which are thin branches.

You can see spots in the picture. This is how a contrast agent appears, which could get into the uterine cavity and penetrate into the fallopian tubes. This picture indicates the absolute patency of the fallopian tubes.

If only one pipe is visible in the picture, then only it is passable; if both are not visible, then their complete obstruction is diagnosed. In medical practice, there are cases of partial obstruction.

The accuracy of the result depends on the preparation of the patient and the choice of the day of the examination, since the HSG should be done in the first half of the menstrual cycle.

Method comparisons

In addition to the hysterosalpingography itself, there are other methods of verification. These include:

• sonography. Such a study is a test of the fallopian tubes by introducing saline. It is inserted through a catheter into the cervix. To obtain results, you must use a specialized ultrasonic device;
• laparoscopy. To conduct the study, specialists make a puncture of the abdominal wall and introduce the device itself - a laparoscope. It is equipped with a video camera and a small flashlight, which allow you to examine the patient's genitals in detail. Often such a study is chosen if it is necessary to remove adhesions;
• blowing out the fallopian tubes. This method is only used if the woman is allergic to the contrast agent given for HSG. To do this, with the help of a rubber tube and pressure gauges, heating and air penetrates inside.

MSG and HSG: what is the difference

Hysterosalpingography differs from metrosalpingography only in name. The differences lie in the compound names of the procedure: “hystera” or “meter”, which, in fact, means the same thing - “womb”. Therefore, preparation for HSG or MSG of the fallopian tubes, as well as the examination process itself, are similar.

Which is better: ultrasound or X-ray

A procedure called hysterosalpingography can be performed in two forms - X-ray or ultrasound. Each of them has both advantages and disadvantages, so it is impossible to give an unambiguous answer to the question. The decision to conduct a particular type of examination is made by the supervising physician based on the patient's condition.

HSG or Echo-HSG

Let us consider in more detail how the standard HSG and echohysterosalpingography differ.

Unlike HSG, Echo-HSG is an ultrasound of the genital organs. So, all the results of the examination will be visible on the monitor directly during the procedure.

Its main advantages are the absence of the slightest exposure and the need for hospitalization.

In order to carry out such a procedure, it is necessary to choose the right time. The ideal period is the beginning of ovulation, since the cervix is ​​as relaxed as possible on these days of the cycle.

In general, the algorithm for conducting echohysterosalpingography does not differ from the standard one. The patient is also injected with a contrast agent, which must pass through the fallopian tubes. The difference lies in the fact that the solution is not administered in stages, but in one dose.

The decision to conduct a HSG or Echo-HSG is made by the doctor himself, after analyzing the patient's medical record.

On which day of the menstrual cycle can a hysterosalpingography be done?

If the doctor prescribed an HSG with an x-ray, then, as a rule, the examination is carried out in the first half of the menstrual cycle, namely from the sixth to the twelfth day, if we are talking about a standard thirty-day cycle. X-rays show good pictures during ovulation. During this period, the endothermy is very thin, so the pictures are clear and without distortion.

Menstruation after the HSG most often comes in the usual mode, and the cycle after the passage of the HSG is not disturbed.

Pregnancy after HSG

After undergoing the procedure, pregnancy after HSG can occur in the current menstrual cycle.

However, medical experts strongly do not recommend starting conception in the same month. The procedure involves x-ray radiation, which can adversely affect the development of the fetus or provoke a miscarriage. In the event that the fact of pregnancy is nevertheless confirmed, experts recommend interrupting it in the early stages.

If a woman plans to conceive, then after the HSG of the fallopian tubes, more than six months should pass.

Chances of conception after HSG

HSG of the fallopian tubes is not only a test of the condition of their patency, but also a medical therapeutic procedure. Therefore, it is after such a study that a woman can become pregnant. If pregnancy does not occur after HSG, then the doctor will look for other causes of female infertility.

There is an opinion on the Internet that after HSG, women have an increased risk of ectopic pregnancy. However, this is just a myth, since the mentioned pathology is directly related to abnormalities in the structure and functionality of the fallopian tubes. They have nothing to do with diagnosis.

When can pregnancy be planned after hysterosalpingography?

Pregnancy after HSG can be planned no earlier than six months later.

This is due to the fact that at the time of the procedure, the patient's body takes a large dose of radiation. Therefore, with an unplanned pregnancy, pathologies in the development of the fetus may occur.

About the delay after the study

The procedure is accompanied by great stress for the body. Therefore, a delay after the HSG for several days is considered normal. If the patient had sexual intercourse after her, then it is worth checking whether the delay is related to pregnancy.

What complications are possible with hysterosalpingography

HSG of the fallopian tubes is an absolutely safe procedure for the patient, therefore, it most often does not cause consequences and complications.

However, if the woman was not aware of an allergy to the contrast solution, irritation in the genital area is likely. In extremely rare cases, the procedure may result in minor bleeding or perforation of the uterus.

If the doctor performed the HSG without following the rules, for example, the devices or the place of examination were not sterile, then a serious infection can develop in the woman's body, up to endothermitis or inflammation of the uterus.

What will be the sensations after hysterosalpingography

On the Internet, many write that “Hysterosalpingography is very painful,” however, if the doctor performed all the manipulations correctly and the patient was prepared, then she will not experience pain discomfort during the procedure.

After the HSG procedure, pain in the lower abdomen may appear. They are provoked by strong contractions of the uterus, which experiences severe stress after the procedure. To reduce such discomfort, you can take an anesthetic drug.

In addition, the patient may detect discharge. They are the remains of a contrast agent and particles of endothermia. For this reason, doctors recommend using sanitary pads for some time after the procedure. Within one or two weeks they will stop.

The HSG medical procedure for detecting fallopian tube pathologies will be useful for women who want, but cannot, have a child. This is an additional preventive and therapeutic examination that can tell a lot about the state of the reproductive system.

This procedure really helps many women. As statistics show, pregnancy after HSG of the uterus and fallopian tubes occurs in the vast majority of patients.

What is the purpose of this survey

Hysterosalpingography is a method of visualization of the uterine (fallopian) tubes and the uterine cavity, based on filling their lumen with a specially injected liquid. The doctor registers the nature of its distribution with the help of equipment, and then analyzes the resulting images.

HSG provides the specialist with reliable information about the patency, location and size of the fallopian tubes. Various deformations, adhesions and neoplasms in the uterine cavity can also be detected. In this case, the patient will be recommended an additional targeted examination in the clinic.

Previously, X-rays with additional contrast enhancement were used for HSG of the fallopian tubes. This method is still used today, although it has several disadvantages. Therefore, at present, preference is given in St. Petersburg to an alternative safe technique - contrast ultrasonic hysterosalpingoscopy (KUZGSS).

X-ray contrast hysterosalpingography is associated with additional (albeit small) irradiation of the patient's pelvic organs, so it is advisable for her to refrain from pregnancy for 3 subsequent cycles. In addition, the drug used may be toxic or cause an allergic reaction. Such shortcomings are devoid of the ultrasonic method. Indeed, at the same time, the uterine cavity and fallopian tubes are filled with a sterile saline solution that is neutral for the woman's body, and the ultrasonic waves emitted by the sensor are completely safe and do not cause discomfort.

Hysterosalpingography (HSG)- a method of X-ray diagnostics of diseases of the uterus and its tubes, based on the introduction of contrast agents into them.

INDICATIONS FOR HYSTEROSALPINGOGRAPHY

Indications for hysterosalpingography are suspicion of tubal infertility, tuberculosis of the uterine cavity and tubes, intrauterine pathology (submucosal uterine fibroids, endometrial polyps and hyperplasia, internal endometriosis), abnormal development of the uterus, intrauterine adhesions, infantilism, isthmicocervical insufficiency. Depending on the purpose of the study and the proposed diagnosis, hysterosalpingography is performed on different days of the menstrual cycle: to detect patency of the fallopian tubes, isthmicocervical insufficiency - in the second phase of the cycle, if internal endometriosis is suspected - on the 7-8th day of the cycle, if submucosal MM is suspected - in any phase of the cycle in the absence of abundant bloody uterine discharge.

CONTRAINDICATIONS OF HYSTEROSALPINGOGRAPHY

Contraindications to hysterosalpingography are general infectious processes in the body (flu, tonsillitis, rhinitis, thrombophlebitis, furunculosis), severe diseases of parenchymal organs (liver, kidneys), insufficiency of the cardiovascular system, hyperthyroidism, acute and subacute inflammatory processes of the uterus and appendages, colpitis, bartholinitis, cervicitis. Hysterosalpingography is not performed in the presence of changes in the clinical picture of blood (increased ESR, an increase in the number of leukocytes) and urine. An absolute contraindication to hysterosalpingography is hypersensitivity to iodine.

HYSTEROSALPINGOGRAPHY TECHNIQUE

For hysterosalpingography, water-soluble contrast agents are most often used: 50, 70% cardiotrast solutions, 60, 76% triombrast solutions, 60, 70% urotrast solutions, 76% verografin solution, etc.

Hysterosalpingography is performed on a radiolucent urological chair with a digital x-ray machine, which makes it possible to reduce radiation exposure to the patient. She is placed on the edge of the table in position for vaginal operations. After treatment of the external genital organs with a disinfectant solution, a two-handed gynecological examination is performed. Spoon-shaped mirrors are inserted into the vagina. Its walls are first wiped with a dry cotton ball, and then treated with a ball moistened with alcohol. The anterior lip of the cervix is ​​grasped with bullet forceps without piercing the mucous membrane of the cervical canal rich in receptors.

For hysterosalpingography, a Schulz-type cannula is used (Fig. 7–1), which consists of a tube 30–35 cm long. Its inner diameter is 1.5–2.0 mm. One end of the tube is connected to a 10 or 20 gram syringe. At the other end, a rubber cone-shaped tip is strengthened, which is inserted into the cervical canal to tightly close the external pharynx. The tube has a movable “rider” with a screw, on which the jaws of the bullet forceps are fixed so that the latter tightly hold the tip in the cervix. The cannula is filled with a contrast agent heated to body temperature. After verifying the tightness of the closure of the external pharynx by introducing a small amount of a contrast agent into the uterine cavity, the vaginal mirrors are removed, and the woman is placed on the table so that the central x-ray beam passes through the upper edge of the womb. To protect the doctor from x-ray radiation, along with a special apron mounted on an x-ray machine for urological studies, a movable lead screen is used to protect the doctor's torso and legs.

Rice. 7-1. Schultz cannula.

For the first image, 2-3 ml of contrast fluid is injected to obtain a relief image of the uterine cavity. After processing and viewing the first image, another 3–4 ml of contrast agent is additionally injected and a second image is taken. In this case, a tighter filling of the uterine cavity is obtained, and the contrast fluid usually enters the tubes and into the abdominal cavity. After viewing the second picture, if necessary, take a third. Usually, 10 to 20 ml of contrast fluid is used for the entire procedure.

When conducting hysterosalpingography on X-ray machines with an elector-optical converter, the television screen shows the gradual filling of the uterine cavity and tubes, the movement of the contrast agent into the abdominal cavity, the pictures are taken as the uterine cavity and tubes are filled.

Hysterosalpingography is performed for inpatients and outpatients. Before being sent for research, a woman is warned that from the moment the menstruation ends, it is impossible to live a sexual life. A week before the procedure, blood, urine and discharge from the vagina and cervical canal are prescribed, a blood test for the Wasserman reaction and AIDS, hepatitis. On the day of the procedure, it is necessary to shave the hair on the external genitalia and, if not
stool, make a cleansing enema. Before the procedure, you must empty your bladder. After the procedure, outpatients rest on the couch for 40–60 minutes.

INTERPRETATION OF THE RESULTS OF HYSTEROSALPINGOGRAPHY

On radiographs in the norm (Fig. 7-2), the cavity of the body of the uterus has the shape of an isosceles triangle, located with the apex down. The base of the triangle (equal to 4 cm) corresponds to the bottom of the uterine cavity, and at the top there is an anatomical internal uterine os. In the lower section, the cavity of the body of the uterus passes into the isthmus of the uterus. The isthmus is 0.8–1.0 cm long, followed by the cervical canal. Its shape can be conical, cylindrical, fusiform and depends on the phase of the cycle. Tubes appear on radiographs as thin, sometimes rather sinuous, ribbon-like shadows. Radiographically, three anatomical parts of the tube can be identified: interstitial, isthmic, and ampullar. The interstitial section is in the form of a short cone, passing after some narrowing into a rather long isthmic section. The transition of the isthmic region to a wider ampullar region is not always distinct on radiographs. Sometimes the longitudinal folding of the mucous membrane of the tube is clearly visible.

The contrast fluid from the ampoule of the tube flows out in the form of a strip and then, to a greater or lesser extent, is smeared over the abdominal cavity in the form of smoke from a burning cigarette. An indicator of good patency of the tubes is the spreading of the contrast agent along the peritoneum to places remote from the ampoule.

Rice. 7-2. Hysterosalpingography with permeable uterine tubes.

Of the causes of tubal infertility, inflammatory processes are in the first place. More often, obstruction of the tubes in the interstitial section is found, and less often, some expansion of this section. This is characteristic of tuberculosis. The obstruction of the tubes in the ampulla gives different pictures depending on the cause and duration of the inflammatory process. The abdominal opening of the tube is often glued together with adhesions, and the exudate stretches the ampullary part of the tube to various sizes (Fig. 7–3). The contrast medium mixes easily with serous exudate and gives a distinct picture of the flask-shaped ampullar part of the tube. Sometimes, after previous treatment, resorption of the contents of the sactosalpinx occurs, its walls collapse. When conducting a vaginal examination before hysterosalpingography, large deviations from the norm are not detected, and a picture of significant sactosalpinxes is revealed on radiographs.

Rice. 7-3. Sactosalpinx.

If, as a result of the inflammatory process, incomplete gluing of the ampullar section of the tube occurs, radiographs reveal that the contrast solution partially penetrates the abdominal cavity through the stenotic opening, and the flask-like expanded ampullar section of the tube is preserved, forming a "ventilated" sactosalpinx. During the adhesive process in the abdominal cavity, the contrast agent penetrates into the encysted cavities, revealing them in the form of contrast formations of various sizes and shapes. Hysterosalpingography in infertility helps to recognize the often asymptomatic tuberculosis of the female genital organs.

The tuberculous process affects the ampullar and isthmic sections of the tubes. There is an obliteration of the lumen of the ampoule. Isthmic sections as a result of damage to the muscle layer become rigid, often expanded and end with bulbous thickenings at the end. Radiologically, the shadows resemble a smoking pipe in shape. With tuberculous endometritis, in advanced cases, deformation of the uterine cavity occurs, its partial or complete obliteration. On the radiograph, a sharply deformed, small-sized uterine cavity is determined (Fig. 7–4).

Rice. 7-4. Tuberculous endometritis and salpingitis.

Hysterosalpingography is of great importance for the detection of malformations of the uterus. With an incomplete septum of the uterus, a septum extending from the bottom, wide in the upper part, at the base is revealed radiographically. With its top, it almost reaches the isthmus, dividing the uterine cavity into two halves. In this case, the angle formed between the two sections of the uterine cavity is acute. Almost the same picture is observed with a bicornuate uterus, but the angle between the two sections of the uterine cavity will be obtuse (Fig. 7-5).

Rice. 7-5. Developmental defects. Intrauterine septum (a) and bicornuate uterus (b).

With an infantile uterus, its cavity on radiographs is reduced, and the neck is elongated so that the ratio of the length of the cervix and the uterine cavity is 3:2 or 1:1. Of the other malformations, a saddle, unicornuate, double uterus is distinguished.

Hysterosalpingography is widely used to diagnose various intrauterine pathologies. With hyperplasia and polyposis of the endometrium, radiographs show uneven contours of the cavity, uneven intensity of the shadow associated with incomplete distribution of the contrast fluid in it, filling defects ranging in size from 0.5 to 0.7 cm.

The shape of the defects is round, oval, sometimes linear. They are located more often in the bottom and at the pipe corners. With large endometrial polyps, the size of filling defects ranges from 1x1.5 to 2x4.5 cm. More often they are single (Fig. 7-6).

Rice. 7-6. Endometrial polyp.

Large polyps are difficult to radiologically distinguish from small submucosal fibroids. In patients with submucosal uterine myoma (MM), the main signs appear on x-rays - an increase in the uterine cavity, its deformation and a large filling defect (Fig. 7–7).

Rice. 7-7. Submucosal uterine fibroids.

The uterine cavity sometimes takes on bizarre shapes: saucer-shaped, tulip-shaped, rounded, crescent-shaped, etc. Filling defects are partially or completely covered with a thin layer of contrast fluid.

With cancer of the body of the uterus, depending on the prevalence of the process, the x-ray picture is not the same.
When the process is localized in one area, radiographs will show a filling defect with uneven corroded outlines in the region of one of the tubal corners or the lateral contour of the uterine cavity. In the diffuse form, when almost the entire endometrium is affected, the uterine cavity will be deformed without clear boundaries with uneven fringed edges and multiple bizarre filling defects with an uneven radiographic shadow.

Hysterosalpingography is a valuable diagnostic method for detecting uterine endometriosis. In patients with this pathology, single or multiple contour shadows in the form of spikes, gaps, pockets are visible. The sizes of these contour shadows are from 2–4 mm to 1–2 cm. More often they are determined on the bottom of the isthmicocervical part of the uterus, less often on the lateral contours of the cavity. Sometimes it is possible to reveal endometriosis of the tubes radiographically, in which many peretubular passages in the form of short strokes or dots depart from the visible lumen of the isthmic section of the tube - a picture resembling a Christmas tree branch (Fig. 7–8).

Rice. 7-8. Endometriosis in the isthmic section of the left fallopian tube.

With the help of hysterosalpingography, intrauterine adhesions are also well recognized. At the same time, single filling defects of various shapes with clear, even contours are more often seen on radiographs in the uterine cavity, which, unlike endometrial polyps, are not filled with a contrast agent even with tight filling of the uterine cavity (Fig. 7-9).

Rice. 7-9. Intrauterine adhesions

Hysterosalpingography is widely used in patients with habitual miscarriages outside of pregnancy in order to detect isthmicocervical insufficiency. Normally, in the second phase of the cycle, the isthmic-cervical section is significantly narrowed (isthmus is not more than 0.4 cm), with isthmic-cervical insufficiency, its significant expansion is noted (up to 1.5 cm or more).

Thus, hysterosalpingography is a valuable additional instrumental method for diagnosing a number of diseases of the uterus and tubes.

FACTORS AFFECTING THE RESULT OF HYSTEROSALPINGOGRAPHY

For the diagnosis of adenomyosis, hysterosalpingography is informative after separate diagnostic curettage on the 2nd day; when diagnosing patency of the fallopian tubes, it is performed in the first phase of the menstrual cycle.

Complications of HSG:

1. Early complications of HSG: vascular reflux (penetration of a contrast agent into the capillary and venous network of the uterus); lymphatic reflux (ingress of a contrast agent into the utero-tubal lymphatic vessels or into the broad ligament of the uterus); perforation of the uterine wall; rupture of a pipe under very strong pressure; allergic reactions.
2. Late complications of HSG: development of inflammatory processes due to infection during the procedure or exacerbation of existing ones.

Hysterosalpingography is a diagnostic manipulation that allows you to assess the patency of the fallopian tubes, as well as the condition of the uterine cavity through x-ray examination.

Indications for HSG

Hysterosalpingography is prescribed to patients during an examination conducted to identify the causes of infertility. Since it is the tubal factor (obstruction or functional insufficiency of the fallopian tubes) that is the most common cause of infertility, a reproductive specialist should assess their condition.

However, this is not the only indication for HSG. This study is also informative for suspected pathologies such as:

• Anatomical anomalies of the uterus (bicornuate uterus, saddle uterus, etc.)
• Fallopian tube tuberculosis
• Intrauterine synechia
• Hyperplastic processes of the endometrium (HPE)
• Submucosal uterine fibroids
• Adenomyosis of the uterus
• Fallopian tube endometriosis
• Isthmicocervical insufficiency

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Contraindications for HSG

Infectious processes of any localization

Cardiovascular pathology

Serious pathologies of the liver and kidneys

Acute or subacute inflammatory processes in the pelvic organs

Dysfunctional uterine bleeding

Pregnancy

Individual intolerance to iodine (due to the fact that all contrast agents contain this substance)

Preparation for hysterosalpingography

Hysterosalpingography is usually scheduled for 7-10 or 16-20 days of the menstrual cycle. Thus, the days when menstruation and ovulation occur should be excluded. It must be remembered that in the cycle when the study is carried out, the patient should use contraceptives.

On the morning of the day when hysterosalpingography (HSG) is performed, a cleansing enema should be administered. Immediately before the study, it is necessary to empty the bladder.

How is hysterosalpingography performed?

HSG is performed on an outpatient basis on a gynecological chair. After treatment with an antiseptic, a thin catheter is inserted through the cervical canal, through which a contrast agent is injected into the uterine cavity. The chair moves under the x-ray machine, after which several pictures are taken. In some cases, it may be necessary to clarify the information received, then after about half an hour a second study is carried out, during which delayed pictures are taken.

Often, patients are interested in what sensations occur during and after hysterosalpingography (HSG). First, with the introduction of a contrast agent, you may feel fullness and heaviness. Cramping pains are possible, which may be due, among other things, to the emotional state of the patient and reflex spasm in the interstitial part of the fallopian tubes. Soreness may persist after the procedure, in connection with which the doctor may recommend taking antispasmodic drugs. Within 1-2 days, red-brownish discharge from the genitals is possible.

We would like to draw your attention to the fact that HSG is not performed at Nova Clinic.

Results of hysterosalpingography

Normally, in the pictures, the uterus, filled with a contrast agent, is defined as an isosceles triangle, located with the base up, from which stripes extend from both sides. These are the fallopian tubes, which can be more even or tortuous. At the exit from the tubes, the contrast agent gradually begins to spread throughout the abdominal cavity.

In case of violation of the patency of the fallopian tubes, the strips are either not visible at all, or are shortened, depending on which section of the tube has a pathology. The sactosalpinx is also visible on the radiograph - it is defined as a rounded expansion in the ampullar section of the tube. Hysterosalpingography makes it possible to identify tuberculous salpingitis and endometritis, since it gives a characteristic picture. In the presence of polyps in the uterine cavity, their number, shape and size can be considered. Submucosal uterine fibroids are defined as an unfilled mass located in an enlarged deformed uterus.

The reliability of the study averages about 80%. In some cases, both false positive and false negative results occur. In particular, tubal spasm in the interstitial region, which occurs as a reaction to the introduction of a contrast agent, can be regarded as evidence of tubal obstruction. Or, on the contrary, under strong pressure, the liquid can penetrate the pipe, but under normal conditions the pipe remains impassable. It should be noted that and are considered the most informative studies that allow diagnosing pathologies of the uterus and fallopian tubes.

HSG (hysterosalpingography) of the fallopian tubes is a method of diagnostic research, which consists in conducting an x-ray examination of the fallopian tubes for patency. The main indication for the procedure is the difficulty in conceiving or carrying a pregnancy (frequent miscarriages, inflammation in the pelvic organs, etc.). The procedure is carried out in a hospital and the patient is constantly under the supervision of a doctor. HSG causes discomfort and in rare cases provokes the development of complications, but the ability to get answers to many questions and identify the cause of infertility for women is a more powerful argument than the consequences.

Indications for HSG of the fallopian tubes

Hysterosalpingography is performed in the presence of strong indications. The patient is referred for the procedure after examining the patient and, in the absence of other possibilities, to conduct an examination of the condition of the uterus and the patency of the fallopian tubes.
Indications for HSG:

Preparation for the procedure and the procedure for its implementation

HSG tubal patency requires careful preparation. This is due to the fact that the procedure is invasive and a dye is introduced into the body (uterus and fallopian tubes). The main tips for preparing for the procedure include: abstaining from sexual life 48 hours before the HSG, stopping douching, using intravaginal suppositories and intimate hygiene products 7 days before the study. These funds can adversely affect the microflora of the genital organs and distort the results of the study.

Before the procedure, a complete gynecological examination, ultrasound of the pelvic organs is mandatory, and the woman passes all the necessary tests to make sure there are no contraindications.

On the eve of the examination, an enema should be performed, pubic hair should be shaved. On the day of the examination, it is necessary to thoroughly wash the external genitalia. The procedure is performed on an empty stomach, so you should refuse to eat, it is allowed to drink 1 glass of clean non-carbonated water. Before HSG it is necessary to empty the bladder.

Hysterosalpingography is performed in a hospital setting. The execution time depends on the goals of the study. So, to study the patency of the pipes and assess the condition of the cervix, the procedure is carried out in the second phase of the menstrual cycle; for the detection of endometriosis, the optimal time is 7-9 days of the cycle; in case of suspicion of uterine fibroids, the examination can be carried out at any time when there is no menstrual flow.

For safety reasons, the procedure is carried out in the first two weeks of the MC - during this period, the uterine mucosa has a small thickness and does not close the exit from the fallopian tubes. In addition, at this time, the woman is 100% not pregnant, so the study does not pose any danger. In the case of the procedure after ovulation, the patient is advised to take a pregnancy test.

The order of the GHA:

The procedure may cause discomfort or pain in the lower abdomen, which disappears a short time after the examination. Tubal HSG is usually not anesthetized, but if the woman has a very low sensitivity threshold, a mild pain reliever may be used.

As a result of studying X-ray images obtained as a result of HSG, the doctor determines the patency of the fallopian tubes and assesses the condition of the uterus and its structure. If the fallopian tubes are completely filled with a contrast agent, then they have good patency. If there is a soldering or other obstruction to the movement of fluid, this will be reflected in the image.

At the end of the procedure, a woman may be disturbed by pulling pains in the lower abdomen, spotting or mucous discharge may be observed. To eliminate unpleasant symptoms, you can take mild painkillers.

Gynecologists do not recommend douching for three days after the procedure, using candles or intimate hygiene products. It is desirable to limit for some time taking a bath and visiting a bath or sauna.

After the HSG, a woman may experience a delay in the menstrual cycle for several days - this is normal and you should not worry about this.

According to statistics and studies, tubal HSG increases the chance of conception. This is due to the fact that the contrast agent improves the functioning of the uterine glands and stimulates the activity of the endometrium.

As a rule, the procedure of hysterosalpingography passes without complications. In rare cases, an allergy to the contrast agent develops. Sometimes there is bleeding or exacerbation of inflammatory processes if a woman suffers from chronic diseases.

Contraindications for the study

In medicine, there are two groups of contraindications for HSG of the fallopian tubes: absolute and relative. The former act permanently, while the latter are temporary, that is, if these factors are eliminated, it is possible to conduct a study.

Absolute contraindications to the procedure:

• Allergy to the contrast agent used during the X-ray or to iodine.
• Heart failure.
• Diseases of the kidneys and liver.
• Pregnancy.

Relative contraindications include:

• The course of an acute viral or infectious process in the body (tonsillitis, acute respiratory infections, boils, etc.).
• Hyperthyroidism.
• Inflammatory processes occurring in the uterus or in the appendages.
• Inflammation of the vagina, cervix, or Bartholin's glands.
• Unsatisfactory test results (increased white blood cell count, the presence of red blood cells and mucus in the urine).

Tubal HSG is an invasive procedure that involves injecting a contrast agent into the uterine cavity and taking x-rays. Such a study is very informative: it allows you to identify obstruction of the fallopian tubes, anomalies in the structure of the internal genital organs and the presence of diseases in the uterus or appendages.

The task of hysterosalpingography in gynecology is to determine the condition of the female reproductive organs. The procedure is non-invasive. But in rare cases, there are complications after.

Features of the procedure

Do a hysterosalpingography available in a medical clinic. Diagnostic rules:

The woman lies on her back, bending her knees.

A mirror is inserted into the vagina to separate the walls so that everything inside is visible.

The cervix is ​​then cleaned and local anesthesia is administered.

Next, a catheter with a balloon at the end is inserted into the vagina, which is inflated during hysterosalpingography. The catheter carries the dye into the uterus, fallopian tube, and abdomen. If the fallopian tubes are blocked, the fluid will try to stretch the tube.

After that, the mirror is removed. The woman is placed under the x-ray machine. Images are taken with a fluoroscopy camera.

If there are deviations and anomalies, you will have to wait about 30 minutes to receive a delayed image. They give clues about the presence of pathologies.

Once the images are taken, the catheter is removed.

X-rays are taken the next day of the procedure to check for scarring on the ovaries.

Watch a video on how hysterosalpingography is done:

When a potential anomaly is identified, hysterosalpingography of the uterus treatment begins immediately.

HSG of the fallopian tubes

Alarming symptoms and complications after hysterosalpingography

Women who undergo hysterosalpingography may experience minor discomfort after the procedure. Unpleasant symptoms include:

slight vaginal bleeding;

mild abdominal pain;

• dizziness, in rare cases, fainting.

Attention! Do not use tampons after the examination. It is better to take a shower and avoid sexual intercourse for two days.

Uterine HSG is considered a non-invasive test with few risks. But some women may develop an infection or an allergic reaction to the contrast agent used during the procedure. You should immediately consult a doctor if symptoms appear:

• severe abdominal pain or cramps;

• smelly vaginal discharge;

  fever or chills

  severe vaginal bleeding;

  itching, rash or hives;

  difficulty breathing or swallowing.

Study Benefits

The benefits of hysterosalpingography are as follows:

the procedure is less invasive, in most cases it passes without any complications;

takes 30-45 minutes;

helps to diagnose uterine anomalies and causes of infertility;

opens blocked fallopian tubes;

has no side effects.

Restrictions

The procedure has limitations:

Does not detect abnormalities in the wall of the uterus, ovaries and pelvic structure.

Not all causes of infertility are identified, such as the inability of a fertilized egg to attach to the uterine wall or an abnormal sperm count.

Alternative Methods

HSG alternatives are:

Laparoscopy is a surgical procedure performed under general anesthesia.

Hysteroscopy - gives a detailed view of the inside of the uterus, but does not reveal a blockage in the fallopian tubes.

Sonohysterography uses ultrasound to look at the inside of the uterus but does not see any abnormalities in the fallopian tube.

It should be remembered that hysterosalpingography is a relatively safe procedure and is often recommended, except in certain cases. If a woman has any questions about this, it is better to discuss this with the doctor in advance.