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Concept
Hysterosalpingography
Summary
Hysterosalpingography (HSG), also known as uterosalpingography, is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the Fallopian tubes. It is a special x-ray procedure using dye to look at the womb (uterus) and Fallopian tubes. In this procedure a radio-opaque material is injected into the cervical canal, and radiographs are taken. A normal result shows the filling of the uterine cavity and the bilateral filling of the Fallopian tube with the injection material. To demonstrate tubal rupture, spillage of the material into the peritoneal cavity needs to be observed. Hysterosalpingography has vital role in treatment of infertility, especially in the case of fallopian tube blockage.
HSG is considered a diagnostic procedure. It is used in the workup of infertile females to assess the patency of fallopian tubes, assess the competency of the cervix or congenital abnormality of the uterus in multiple miscarriages, assess the patency of fallopian tubes after surgery or tubal ligation, or before reversal of tubal ligation. Rarely, HSG is used to assess the integrity of a Caesarean scar.
Occasionally, HSG may also have therapeutic benefits for infertility treatment. When oil-based contrast is used, rates of pregnancy increase by about 10% compared to water-based contrast. A meta-analysis revealed 3.6 times greater odds (OR = 3.6) of pregnancy with oil-based contrast compared to no hysterosalpingography. This effect is thought to be due to the flushing action of the contrast into the uterus that causes dislodgement of mucus plug, debris, or opening of mild adhesions in the fallopian tubes.
HSG is contraindicated during menstruation, suspected cancer, pregnancy, unprotected sexual intercourse during the menstrual cycle, any purulent discharge from the vagina, or if the individual was diagnosed with pelvic inflammatory disease six months previously. For those with hypersensitivity to contrast, HSG is relatively contraindicated.
Either high osmolar contrast material (HOCM) or low osmolar contrast material (LOCM) can be used.
Official source
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