A hysterosalpingogram is an X-ray of the uterus and fallopian
tubes which allows visualization of the inside of the uterus and tubes. The picture will reveal
any abnormalities of the uterus as well as tubal problems such as blockage and dilation
(hydrosalpinx). If sterilization reversal is planned, the point at
which the tubes are blocked can be seen. This helps to plan the reconstructive procedure.
If the tubes are not blocked by scar tissue or
adhesions, the dye will flow into the abdominal cavity. This is a good sign but it does not
guarantee that the tubes will function normally.
It does give a rough estimate of the quality of
the tubal structure
and the status of the tubal lining. Some cases where the tubes
appear to be
blocked where they join the uterus, may in fact be
normal. Often blockage at this location may
be due to spasm of
the opening from the uterus into the tube or from accumulated
debris and
mucus blocking the opening. This can be managed by
passing a very thin
catheter into the fallopian tube either at
the time of hysterosalpingogram or during a
hysteroscopic procedure.
A hysterosalpingogram may also indicate endometrial polyps, submucus fibroids,
intrauterine adhesions (synechia), uterine
and vaginal septa uterine cavity abnormalities, or the after-effect of genital
tuberculosis. The hysterosalpingogram may or may not be able to detect pelvic
adhesions, mild hydrosalpinx, small polyps, endometriosis, tubal phimosis (clubbing
of the fimbria at the end of the tube), or immotility of the tube. Other tests,
such as hysteroscopy saline sonohysterography or laparoscopy
may be necessary to accurately evaluate your uterus.
Although the purpose of the hysterosalpingogram is not therapeutic, sometimes
forcing dye through the tube will dislodge any material which blocks it. A number
of women have become pregnant following a hysterosalpingogram without further
treatment.
Generally there is no special preparation needed for this test. However, depending
upon your diagnosis, you may need to take antibiotics to guard against possible
infection. To ensure that you are not pregnant, the study is done between Day
7 and 10 of your cycle. Prior to the procedure you may take an anti-inflammatory
medication (Aleve or Motrin). A small catheter is placed into the cervix and the
dye is injected. You may feel heavy cramping during, and for several hours following
this procedure. Expect a sticky vaginal discharge for a few days as the dye is
expelled from the uterus. Use a pad or panty liner during this time to allow fluid
to escape. Any dye that remains will be absorbed without any ill effect.
NOTE: Be sure we are aware of any allergies you may have to Iodine,
Betadine, or Novocaine prior to the procedure.
If cramping does not subside or if you develop severe abdominal pain or fever
following this test, please notify Georgia Reproductive Specialists at 404-843-2229.
When the HSG is Normal
