Hysterosalpingography

X-ray examination of the female reproductive organs

Parts of the Body Involved

Uterus
Fallopian tubes
Cervix
Vagina

Reasons for Procedure

Hysterosalpingography is used to evaluate the following:

Infertility
Heavy bleeding
Lack of menstrual period (amenorrhea)
Painful menstruation
Multiple miscarriages
Uterine adhesions (scar tissue)
Polyps (small growths)
Tumors
Inflammation
Prior tubal surgery
Congenital uterine or tubal defects
History of exposure to DES (diethylstilbestrol)
Location of "lost" IUD (intrauterine device)

Risk Factors for Complications during the Procedure

This procedure should not be done if you are pregnant.

Factors that increase the risk for complications include:

Current or past pelvic inflammatory disease (PID)
Untreated sexually transmitted disease (STD)
Recently performed dilation and curettage procedure (D & C)
Vaginal bleeding of unknown cause
Menstruation
Pre-existing heart or kidney disease

What to Expect

Prior to Procedure

Your doctor will likely do the following:

Physical and pelvic exam
Cultures, possibly (especially if you have a history of PID)

In the days leading up to the procedure:

Schedule the procedure within the first 10 days after your period to precede ovulation and decrease the possibility of disturbing an unknown pregnancy
Take any pain medication or antibiotics as ordered by your doctor
You may be asked to take a laxative or enema
Have a light meal the night before and do not eat or drink anything after midnight, unless told otherwise by your doctor
Wear comfortable clothing
Arrange for a ride to and from the procedure

During Procedure - possibly a sedative

Anesthesia - None

Description of the Procedure - You will lie on a special x-ray table, called a fluoroscopy table, with your feet in stirrups or pulled up to your chest. The doctor does a pelvic exam to assess the position of the uterus and check for tenderness or inflammation. After inserting a speculum in the vagina, the doctor cleanses the cervix and upper vagina, and then gently inserts a tube that attaches to the cervix. You are then repositioned and the contrast material is slowly injected through the tube and into the uterus. The doctor watches on a special type of machine called a fluoroscopy and takes x-ray photos (called "films") at different times during the procedure. The table may be tilted or you may be asked to roll from side to side to spread the contrast material and obtain better views. When x-rays of all the areas have been completed, the instruments are removed.

After Procedure - You'll be observed for signs of an allergic reaction and bleeding for about 30 minutes

How Long Will It Take? 15 - 45 minutes

Will It Hurt? Most patients report some discomfort and cramping during this procedure. If there is a blockage, it may cause more intense pain. Your doctor may order pain or sedating medications to be taken one hour before the procedure to reduce your pain.

Possible Complications:

Infection
Excessive bleeding
Adverse reaction to contrast material
Increased and persistent pain
Perforation of the uterus
Injury to a recently fertilized egg

Average Hospital Stay - None

Postoperative Care:

Expect some bleeding for a few days after the procedure
Use over-the-counter pain medication to relieve discomfort, as needed
If an antibiotic has been ordered to prevent infection, take all of the pills that were prescribed
Do not stop the medication, unless told otherwise by your doctor
Do not douche, use tampons, or engage in sexual intercourse for 48 hour after the procedure

Outcome

A radiologist interprets the x-ray films and reports what was found to the doctor who ordered the exam. Your doctor will then make recommendations for treatment.

Call Your Doctor If Any of the Following Occurs

Increased pain
Heavy vaginal bleeding
Signs of infection, including fever and chills
Abdominal pain
Nausea, vomiting
Itching, hives, rash
Difficulty breathing and/or swallowing