Hysterosalpingography, also known as “uterosalpingography”, is a radiographic (or x-ray) examination of a woman’s uterus and fallopian tubes, especially in cases of female infertility. It utilizes an immediate form of x-ray called fluoroscopy with a specific contrast material.
X-rays (or radiographs) are non-invasive, painless medical imaging tests that help in diagnosing and treating medical conditions. X-ray images are obtained by exposing the body part to a small requisite dose of ionizing radiation to produce radiographic pictures of the body’s interior.
Describing fluoroscopy, it is a specialized x-ray technique that images internal organs during movement. Fluoroscopy utilizes either a continuous or pulsating x-ray beam to produce a series of images which are then projected onto a fluorescent screen, or television-like monitor. The still images or videos are then captured and stored into a computer electronically.
How does a hysterosalpingography work ?
Hysterosalpingography utilizes an immediate form of x-ray imaging called fluoroscopy. While taking a hysterosalpingogram, the uterus and fallopian tubes are to be filled with a water-soluble contrast material and then subjected to an x-ray beam that helps the radiologist view and gauge their anatomy and function.
What are the Indications for hysterosalpingography ?
Hysterosalpingography is first and foremost used to examine women with infertility as it allows for evaluation of the shape, size and structure of the uterus, the openness and patency of the fallopian tubes, and the presence or absence of any pathology.
In repeated miscarriages, the procedure can detect either congenital or acquired abnormalities of the uterus and fallopian tubes as well as their severity. These defects include are as follows.
- Adhesions or Scar Tissue
- Uterine fibroids/ Other tumours
- Fallopian tube pathology (Blocked tubes, tubal ligation, sterilization closure or disease related blockages).
What are the contraindications for hysterosalpingography ?
- Current pregnancy : The radiographic (x-ray) dosage has to be minimized to prevent damage to the unborn foetus.
- In active inflammatory conditions, this procedure is best avoided.
- Your doctor has to be informed about any recent illnesses, allergies (particularly if seen in response to iodinated contrast materials) and concurrent medications you’re taking, to prevent any untoward complications.
- Inform your physician if you are affected by any chronic pelvic infection or any sexually transmitted diseases.
What is the procedure for hysterosalpingography ?
Ideally, the hysterosalpingography procedure should be performed around a week after menstruation but prior to ovulation to be sure that you are not pregnant during the examination. Many imaging tests are better avoided in pregnancy so as to not expose the foetus to unnecessary radiation. If it is absolutely necessary, precautions have to be taken to lessen the radiation exposure to baby.
On the night prior to procedure, a laxative or an enema may have to be taken to clear your bowels, so that the uterus and adjacent structures are delineated clearly. You may also be given a mild sedative to decrease any potential discomfort or stress.
Jewellery, tight clothing, any removable dental appliances, eye glasses and other metal objects that might distort x-ray images are to be removed.
This examination is typically done as an outpatient procedure and is performed much like a gynaecological examination. The position is with your back on the examination table, with either bent knees or feet held up in stirrups. A speculum will be inserted into the vagina. After cleaning the cervix, a catheter is to be inserted into the cervix. After removing the speculum, a fluoroscopy camera is then positioned into place. The contrast material is then made to fill the entire uterine cavity, fallopian tubes and peritoneal cavity via the catheter and fluoroscopic images are taken using the camera.
After completion of procedure, the catheter is removed and you may sit up.
The radiologist will determine if all the necessary images have been obtained for adequate diagnosis. The hysterosalpingogram is usually finished within 30 minutes.
What are the complications for hysterosalpingography ?
This examination causes only slight discomfort and mild cramping when the catheter is placed and the contrast material is injected into the uterus, but this feeling should not last very long. There may also be vague lower abdominal pain, but this also should not be long lasting. It is normal to have some vaginal spotting for a few days after hysterosalpingography.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
