Hysterosalpingography, also known as uterosalpingography, is an examination of the uterine cavity and fallopian tubes using X-ray imaging and a contrast medium. The primary purpose of the examination is to determine whether the fallopian tubes, through which the egg passes from the ovary to the uterus, are open and functioning properly. This procedure is commonly performed as part of an infertility evaluation. It is not performed on women who are pregnant, have pelvic inflammatory disease, or are experiencing unexplained bleeding.

Reasons for a Hysterosalpingography

While a hysterosalpingography is most frequently used to examine women who are having difficulty becoming pregnant, it can also be performed to determine the cause of repeated miscarriages or to check the efficacy of a hysteroscopic tubal occlusion, an operation to prevent pregnancy, commonly known as "having the tubes tied." Additionally, a hysterosalpingography can help doctors:

  • Evaluate the uterus for any anatomical abnormalities
  • Detect tumors, polyps, adhesions, or foreign bodies in the uterus
  • Detect any blockage in the fallopian tubes

Beyond being a diagnostic test, the hysterosalpingography is sometimes used to treat detected abnormalities by opening up a blocked fallopian tube. In some cases, just the injection of contrast dye through the fallopian tube dislodges material causing a blockage. When a hysterosalpingography clears blockages within the fallopian tube, the chances of a successful pregnancy increase.

The Hysterosalpingography Procedure

Optimally, a hysterosalpingography is scheduled about a week after menstrual bleeding has stopped in order to reduce the risk of infection and ensure that the patient is not pregnant. A urine sample is also taken to rule out a possible pregnancy.

Prior to the procedure, the patient may be prescribed antibiotics to prevent infection. On the day of the procedure, a tranquilizer may be administered to help the patient relax. As the procedure begins, the cervix is cleaned and a local anesthetic is injected. A catheter is inserted through the vagina into the cervical canal and contrast dye is injected. The dye gradually fills the uterine cavity and the fallopian tubes, making these areas more visible on X-Ray films. While the contrast dye is flowing, the physician takes radiographic pictures using fluoroscopy.

Most patients experience some pressure and cramping during the procedure. If the fallopian tubes are blocked, or if dye leaks out of the tubes, patients may experience more pain.

Risks of Hysterosalpingography

While a hysterosalpingography is considered a safe procedure, any invasive procedure carries risks. The risks of a hysterosalpingography include:

  • Allergic reaction to contrast dye
  • Endometritis
  • Infection of the fallopian tube (salpingitis)
  • Pelvic infection
  • Perforation of the uterus

Some women may experience lightheadedness or fainting during or after the procedure.

Recovery from Hysterosalpingography

Patients may experience a sticky vaginal discharge, light bleeding or spotting, or cramping for a few days after the procedure, as the dye is expelled from the uterus. Any contrast dye that remains will be absorbed without any side effects.

Although spotting, light bleeding, or cramping may be expected after a hysterosalpingography, any heavy bleeding, fever, or severe abdominal pain requires immediate medical attention.

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