Hysterosalpingography : Procedure and Video

Procedure, Indications and Hazards of Hysterosalphingography

HSG is an operative procedure whereby a radiographic study of the interior of the uterotubal anatomy is made using a contrast media.

Indications of HSG

1. To note the tubal patency in case of Infertility or following the tubal operation
2. To detect uterine malformation in the recurrent mid trimester abortion
3. To diagnose the cervical incompetency
4. To identify the translocated IUD wheter lying inside or outside the uterine cavity
5. To diagnose the uterine Synechiae
6. To confirm the diagnosis of secondary abdominal pregnancy
7. Incidental diagnosis of submucous fibroid or an uterine polyp or hydrosalpinx or nodular tube is an additional gain.

Steps in the Procedure

1. Procedure room- Radiology department
2. Anesthesia : Not required
3. Patient is askes to empty her bladder.
4. She is placed on dorsal position with the buttocks on the edge
5. Internal examination is the done
6. Posterior vaginal speculum is introduced and the anterior lip of the cervix is held with Vulsellum
7. Uterine sound is passed
8. Hysterosalpigographic cannula is fitted with a syringe containing radio-opaque dye- Urografin- Sodium Ditriazoate. About 5-10 ml .
9. Speculum and vulsellum are removed but the cannula is kept intact.
10. Immedicately X-ray is done in AP view. Cannula is removed and after 10 minues another Xray is done.
11. The tubal patency is evidenced by spillage of dye.

Complications

1. Peritoneal Irriation and pelvic pain
2. Vasovagal attack
3. Intravastation of Dye in venous or lymphatics
4. Flaring of Pelvic infection

Hysterosalpingography Procedure Video