One common cause of infertility is obstruction of the fallopian tubes. There are several diagnostic methods of this state. However, the most used of them is the consequences of which are not very pleasant, but quite tolerable.

This study can be held on different days menstrual cycle as prescribed by a doctor. You should not overeat the night before and eat and drink on the day of the examination. Before HSG, you need to do an enema, empty your bladder and shave your pubic hair.

HSG, the consequences of which can be minimized by undergoing the necessary examination before it, is usually performed without anesthesia, however, at the request of the patient, light anesthesia can be used. A week before the test, you need to take urine and blood tests, make vaginal smears and be tested for HIV, syphilis and hepatitis.

One of the most unpleasant but possible consequences of HSG is the inflammatory process. Therefore, after the procedure you need to pay close attention to your health. Fever, pain and after HSG for more than three days are a reason to consult a gynecologist.

The study cannot be carried out if there is an inflammatory process in the genital tract or if it has recently been suffered. Exacerbation general illness is a contraindication to the procedure (pyelonephritis, influenza, pneumonia).

X-ray contrast agent may cause allergies. Therefore, it is necessary to find out the reaction to the drug used; as a rule, it contains iodine.

In a cycle in which HSG is performed, the consequences of which can be pleasant, it is imperative to protect yourself, even if long time pregnancy did not occur. This is due to the fact that after the study the likelihood of its occurrence increases significantly due to the washing effect.

A contrast agent injected into the tubes eliminates small adhesions that previously interfered with conception. This is truly an established fact, which is why many women have high hopes for this procedure.

HSG, the results of which are of great value for identifying the causes of infertility, is carried out in the X-ray room at special chair. After a two-handed examination, several images are inserted into the uterus and taken.

This procedure tolerated differently by patients. Some only note discomfort, others complain of severe pain. Most likely this is due to the sensitivity threshold, which is individual for each person.

After an HSG, there may be some slight bleeding, so you should take a sanitary pad with you. It usually goes away within a couple of hours.

After research there are painful sensations, reminiscent of the beginning of menstruation. They are especially noticeable in a sitting position. A slight rise in temperature and mild symptoms are also possible. These phenomena are normal in the first few days.

As a result of the HSG, the patient receives images in her hands, from which you can see whether they are passable and, if not, then in which part. In addition, they can be used to diagnose diseases such as endometriosis, tuberculosis of the reproductive system, various pathologies, including congenital ones (bicornuate, saddle-shaped).

It is important to remember that in 20% of cases, HSG gives a false diagnosis of tubal obstruction. This can happen if a woman has long and narrow hair. Then the contrast agent simply does not have time to get into abdominal cavity.

In addition, due to stress and anxiety, spasm of the tubes may occur. Therefore, it is necessary to drink no-shpa before the study. To prevent the inflammatory process, the doctor may prescribe a course of suppositories, tampons or antibiotics.

Thus, HSG, the consequences of which can be both negative (inflammation) and positive (long-awaited pregnancy), is a very informative procedure. It allows you to check the patency of the fallopian tubes, detect their pathologies, as well as the uterus. To prevent negative consequences it is necessary to follow the recommendations of the gynecologist.

Hysterosalpingography is an X-ray examination internal cavities the uterus and its tubes after the introduction of a special dye, clearly visible on an x-ray due to its contrast. This method allows, with minimal intervention and a very low concentration of X-rays, to obtain detailed diagnostic picture some specific female diseases.

This procedure has several different names depending on how it is carried out, but many of them are simply synonymous words. For example, metrosalpingography is performed in exactly the same way. Essentially, this is the same procedure.

Salpingography can also be performed without x-rays using. To do this, they do not use a contrast liquid, but a regular saline solution; the cavities filled with it are clearly visible on the ultrasound screen. This method is less painful, but, unfortunately, also less accurate. In addition, the advantage of x-rays is that the patient retains an image of the uterus and tubes, which makes it possible to monitor the dynamics of recovery.

To the advantages of ultrasonic HSG uterine pipes can be classified as small healing effect, the liquid seems to clean the pipes, making the passage wider, which is a positive aspect in the treatment and prescription of CGS in gynecology.

Preparation for salpingography is important not only to achieve the most accurate result, but also to minimize possible negative consequences. This procedure is often prescribed as diagnostic test in case of infertility, therefore, even with the slightest suspicion of pregnancy, it is absolutely impossible to carry out. The ideal period is considered to be the interval between menstruation and the expected time of ovulation, in order to exclude a possible pregnancy.

In the presence of inflammatory diseases and STDs there are a number of contraindications for this study. Therefore, you must inform your doctor about them during the examination.

Before the procedure (in the evening), an enema or laxatives may be prescribed to keep the intestines clean and not obstruct vision. Sometimes the doctor may prescribe additional sedatives or painkillers, as well as anti-inflammatory or antibacterial drugs. Therefore, if you are already taking any medications during the procedure, you must inform us about this.

The procedure itself does not take much time; the woman is asked to undress and remove metal jewelry, after which she should sit on a gynecological chair. The doctor installs a catheter into the uterus, through which the fluid necessary for the study is gradually introduced. X-rays are done faster, but pain may occur when contrast is injected. During an ultrasound, a saline solution is administered; this is not so noticeable, but the examination itself takes a little longer.

Indications for HSG are often the inability to become pregnant, but in addition, the study is prescribed for:

• Suspicion of oncological neoplasms inside the genital organs.
• Suspicion of the uterus.
• Suspicions of degeneration of the inner layer of the mucosa or speckled neoplasms on it.
• Suspicions of all kinds internal inflammation associated with fluid or blood accumulation.
• Suspicions of pathology in the development of female genital organs and/or onset.
• Preparations for artificial insemination or before egg retrieval.

Sometimes the patient is given the opportunity to choose the type of study. or x-ray, but most often the method is determined by the doctor based on the clinical picture.

Contraindications for HSG are:

1. Pregnancy or even suspicion of possible pregnancy.
2. Allergy to any component of the contrast agent.
3. Inflammatory or infectious diseases female genital organs, including external ones.
4. Severe pathological diseases of the heart or blood vessels.

Consequences and recovery after the study

During first few days There may be slight discharge after HSG. The discharge may be mucous, if it bleeds a little, this is also absolutely normal. There may also be unpleasant, painful sensations in the lower abdomen, which can easily be eliminated by taking painkillers. Some women may lose their periods for several cycles after the procedure.

Discharge after HSG fallopian tubes or cavities are usually scanty and disappear completely in 3-4 days. When contrast liquids are used, the glands are stimulated, which increases the likelihood of conception for some time. Sex life after HSG does not change in any way, but for the first few days it is still worth abstaining.

Complications after this procedure are extremely rare, especially if the doctor initially received the information in full and there were no contraindications. Complications include:

• Minor bleeding after SG of fallopian tubes and cavities.
• Allergic reactions to components of contrast fluid.
• Increased inflammatory processes, so doing HSG with them is highly not recommended.

TO possible risks The influence of X-rays can also be attributed, but, performed once, this procedure will not affect your health in any way.

It is worth remembering that this procedure itself does not provide a complete picture of diseases related to gynecology; the doctor usually prescribes a number of tests and studies for it, regardless of the result. Treatment can only be carried out by a doctor of appropriate qualifications, rely on self-medication and advice from the Internet absolutely not worth it.

Very often, infertility in women is caused by obstruction of the fallopian tubes. The most common way to diagnose this problem is hysterosalpingography (HSG). Its consequences bring considerable discomfort, but they are tolerable.

Conditions

Such a diagnosis can be carried out on any day of the menstrual cycle; it must be prescribed by the attending physician. Before the HSG, you should give an enema and shave your pubic hair. In addition, diagnostics are performed when the bladder. If there is a need for HSG, the consequences of the procedure can be reduced if examined in advance. In most cases, manipulations are carried out without anesthesia, but at the request of the woman it is possible application of lung anesthesia A few days before diagnosis, it is necessary to take urine and blood tests, smears from the vagina and cervical canal, and be tested for HIV, syphilis and hepatitis.

GHA. Consequences and contraindications

The greatest discomfort after hysterosalpingography is caused by the inflammatory process. To prevent it, the doctor may prescribe suppositories, antibiotics or tampons. In cases of symptoms such as fever, pain and bleeding that last more than three days, you should consult a gynecologist. If a woman has or has recently had inflammation in the reproductive system, HSG cannot be done.

Also a contraindication for this procedure is acute stage some diseases such as pyelonephritis, pneumonia, influenza. When conducting GHA consequences may be expressed in allergic reaction on the substance that the specialist will use during the study. Therefore, before carrying out the procedure, you need to do a test analysis. Usually the substance contains iodine. Since the likelihood of conception increases significantly after the flushing effect, it is recommended to use contraception in the cycle in which the diagnosis was performed.

How is the procedure done?

A contrast agent is injected into the fallopian tubes, which is capable of dissolving small adhesions that cause infertility. This is why most patients planning pregnancy really hope for HSG. The examination is carried out on a specially designed chair in the X-ray room. The contrast agent is administered after a two-handed examination, after which photographs are taken. For some women, this procedure causes discomfort, while others feel sharp pain. This is due to different sensitivity thresholds.

special instructions

After undergoing HSG, the consequences may be expressed in the form of slight bleeding. It stops after about two hours. In addition, some patients experience pain reminiscent of the first days of menstruation. It usually occurs while sitting. It's also possible slight increase body temperature. Women often complain of discharge after HSG.

This should not be a cause for concern in the first few days. After HSG, the results (images) are given to the patient. Using them, you can determine the patency of the tubes and identify diseases such as tuberculosis of the reproductive system, endometriosis, the presence of polyps and others. However, there is a chance (20% of cases) that the study will provide false result. This is possible if the patient has long and narrow fallopian tubes and the X-ray contrast agent does not have time to reach the abdominal cavity. To avoid spasm of the tubes under the influence of stress and anxiety, you should drink the drug "No-Shpa" before performing an HSG (the consequences in this case will be minimal). Of course, this diagnosis causes a little discomfort, but it significantly increases the likelihood of conception. Using HSG, you can not only check the fallopian tubes for patency, but also identify their pathologies.

Hysterosalpingography (HSG, metrosalpingography)- this is the method x-ray examination the uterine cavity (hysterography) and fallopian tubes by artificially contrasting them. Hysterosalpingography is used to determine the cause of infertility, if a malformation of the internal genital organs, submucosal fibroids, endometrial cancer, fallopian tube tumors, adhesions, etc. is suspected.

HSG is preferably performed in phase II of the menstrual cycle (16-20 days). However, if internal endometriosis is suspected, it is advisable to carry out this study in phase I, the day after diagnostic curettage or at the end of menstruation. To perform HSG, the doctor uses water-soluble contrast agents (Verografin, Urografin, etc.).

Preparation for hysterosalpingography (HSG)

1. When performing hysterosalpingography, the patient should be protected from pregnancy during the menstrual cycle in which the HSG will be performed;
2. 5-7 days before the study, perform a flora test of blood, urine and discharge from the cervical canal and vagina (without the results of these tests, GHA has no right to conduct);
3. on the day of the HSG procedure, a cleansing enema is necessary, immediately before hysterosalpingography - to empty the bladder.

Hysterosalpingography is performed without anesthesia, so if you have increased pain sensitivity or are afraid that hysterosalpingography will be painful, discuss pain relief with your doctor before HSG.

Don't forget to bring sanitary pads with you. Some clinics require you to take a robe, change of shoes and bed linen with you (as a rule, according to reviews, these are government-owned medical institutions and hospitals). The cost (price of the HSG procedure) depends on the clinic, as a rule, in state hospitals referred from antenatal clinic Hysterosalpingography is performed free of charge if you have an insurance policy.

How is the HSG procedure performed?

After treatment of the vagina and cervix alcohol solution iodine, a uterine cannula is inserted into the cervical canal, through which 10-12 ml of a 60-76% solution of a water-soluble radiopaque substance, the temperature of which is 36-37°, is slowly introduced into the uterine cavity under fluoroscopy control. As the uterine cavity and fallopian tubes fill, X-rays are taken. If radiographs do not show filling of the fallopian tubes after 3-5 minutes, repeat images are taken after 20-25 minutes. Radiographs are used to assess the condition of the cervical canal, the position of the uterus, the configuration and size of its cavity, the location and patency of the fallopian tubes.

For the patient, the HSG procedure looks like this:

You come to the clinic with the results of blood, urine and smear tests, and change clothes. The nurse will take you to the office where the hysterosalpingography procedure will be performed. You need to undress and lie on the couch on your back, with a pillow placed under your back and pelvis. When treating the genitals with a disinfectant, there will be a slight tingling sensation. The cannula insertion procedure is absolutely painless. When applying a radiopaque solution, there is a feeling of filling of the uterus, distension, pressure, and at the end of the process it may be a little painful (as it is painful on the first day of menstruation). In this position, you will need to freeze for a while so that the doctor takes a couple of pictures. Next, the liquid is pumped out.

An HSG study may be accompanied by a short-term increase in body temperature, bleeding and abdominal pain (go away on their own), and allergic reactions. It is rare to experience fainting after an HSG procedure.

The nurse will take you back to the room, where you will lie down until your abdominal pain goes away (from 15 minutes to several hours, depending on individual characteristics organism).

For the next 5-7 days after the procedure, it is necessary to put tampons with medications to prevent inflammatory processes in the pelvic organs (placed in a day hospital).

Consequences of hysterosalpingography

After HSG, you may smear blood for about a week, this is normal. If the bleeding is severe or prolonged or abdominal pain does not go away, you should consult a doctor.

Contraindications for hysterosalpingography

Metrosalpingography is contraindicated in acute or subacute inflammatory processes genitals, acute infectious diseases, thrombophlebitis.

Archived version

Detailed explanation hysterosalpingography (HSG, x-ray of the uterus and fallopian tubes): what it is, how to prepare for it, how it is performed, possible consequences what its results might mean

An updated and improved version of information on hysterosalpingography (HSG) in the diagnosis of tubal obstruction is available on the Infertility and Difficulty Conceiving page. Science-based guidance for women and men.

Contents:

In what cases should HSG not be performed?

Hysterosalpingography (HSG) is strictly prohibited:

• During pregnancy;
• If you are allergic to contrast media;
• If you have an infection in the vagina or cervix.

In this regard, before performing HSG, doctors often recommend pregnancy test, general gynecological examination And bacteriological smear from the vagina.

How to prepare for GHA?

If you are scheduled for hysteroscopy:

1. Avoid sexual intercourse 1-2 days before the examination.
2. 1 week before the examination, do not douche and refuse to use any intimate hygiene products.
3. 1 week before the examination, stop using any medications such as vaginal suppositories, tablets or sprays, if their use before hysterosalpingography has not been previously agreed with the doctor.

On what day of the cycle is HSG usually performed?

As a rule, HSG is performed within the first 2 weeks after the end of the next menstruation. The need for hysterosalpingography at this time is due to the fact that during this period the woman cannot yet be pregnant (see. ), and also with the fact that the mucous membrane of the uterus in the first weeks after menstruation has a relatively small thickness and does not block the entrances to the fallopian tubes.

What can the results of HSG mean? How can you understand whether the fallopian tubes are passable or not?

As mentioned above, during hysterosalpingography the doctor receives x-rays, in which the area of ​​the uterine cavity and fallopian tubes is highlighted using a contrast agent.

If the doctor sees on the images that the contrast agent has penetrated from the uterine cavity into the fallopian tubes, filled them and then flowed into the abdominal cavity, he can conclude that the fallopian tubes are passable.

On the contrary, if the doctor sees that the contrast agent has stopped at some level of the fallopian tube (or tubes), he can assume that the tube (tubes) are obstructed.

What other diseases besides obstruction can the doctor determine from the images?

By studying the structure of the images, the doctor can determine, in addition to tubal obstruction, diseases such as , or adhesions (synechia) in the uterine cavity, hydroomentum, peritubar adhesions (that is, adhesions pressing on the fallopian tube from the outside).

How accurate are HSG results?

Even when performed correctly, hysterosalpingography results can be highly inaccurate. One study that examined the ability of GHA to detect diseases of the fallopian tubes showed that the sensitivity of this examination (that is, the ability to detect a disorder if it exists) is about 65%, and the specificity (that is, to determine which disease is present out of all possible ones) is about 80%.

When it comes to checking the condition of the uterine cavity, HSG results are approximately 80% accurate. In this regard, according to some experts, instead of HSG, a test should be performed to check the condition of the uterine cavity. .

A comparison of the accuracy of HSG with other methods for determining tubal patency is presented in .

What consequences and complications can occur after HSG?

Overall, hysterosalpingography is considered a safe procedure and usually occurs without any serious complications or sequelae.

However, in very rare cases, you may develop a severe allergic reaction to the contrast material during this test. As a rule, this reaction develops in women who have already had severe allergies to a contrast agent (which was used during other examinations) or in women suffering from bronchial asthma and those who are allergic to many chemicals.

Also very rarely, uterine perforation and bleeding are possible during HSG. In some cases, infection may develop after HSG (see. , ).

What is the risk of the radiation I receive during an HSG?

We have already said above that hysterosalpingography uses X-ray radiation, which is a type of ionizing radiation.

However, the average radiation dose a woman typically receives during an HSG (0.4 to 5.5 mGy) is much less dose receiving which can lead to tissue damage or mutations (the maximum safe dose is considered to be a dose of 100 mGy).

Therefore, the radiation you may receive during a hysterosalpingogram may not cause any serious harm to you or your future children.

Recovery period after HSG

During the first few days after hysteroscopy, scanty, bloody or mucous discharge from the vagina may appear. There may also be minor pain in the perineum or lower abdomen. As a rule, these symptoms pass quickly and do not require any special treatment. At severe pain You can take a pain reliever (for example, 1 tablet of Ibuprofen).

Within 2-3 days after hysteroscopy you cannot:

• Use vaginal tampons (you can use regular pads);
• Do douching (see also How safe is douching?).
• Take a bath, visit a sauna or bathhouse (you can take a shower).

What does discharge (bloody or with an unpleasant odor) after HSG mean?

Minor spotting after hysterosalpingography may be due to minor trauma to the cervix and should not be a cause for concern. However, if a few hours or days after the HSG you notice the appearance of abundant bloody discharge, which do not look like menstruation - be sure to consult a doctor for examination.

Also consult your doctor if after HSG you notice the appearance of discharge with unpleasant smell– such discharge may be a sign of infection.

What could a missed period after HSG mean?

A delay in menstruation for several days after hysterosalpingography is most often associated with stress caused by the examination.

However, in all cases where there is a delay after HSG, it is necessary to ensure that it is not related to pregnancy.

Sexual life (sex) after hysterosalpingography

Typically, doctors recommend abstaining from sex for the first 2-3 days after hysterosalpingography. This is necessary in order to reduce the risk of infection through the cervix, which was dilated during the administration of the contrast agent.

Is it true that HSG promotes conception?

Existing on this moment Clinical evidence suggests that hysterosalpingography may indeed improve a woman's ability to conceive, especially when an oil-based contrast agent is used for the examination.

The exact reasons for this effect of HSG on the likelihood of pregnancy are still unknown. Some experts suggest that contact of the uterine lining with an oil-based contrast agent increases its ability to support embryonic development. early stages pregnancy.