Hysterosalpingography is an invasive procedure, that is, it requires penetration of instruments into various organs and body cavities. It is the invasiveness of hysterosalpingography that is the factor that underlies the possible consequences and complications of the manipulation. The entire set of possible consequences of hysterosalpingography is divided into early and late. Early complications arise directly during the procedure itself and within a few hours after it. Late complications of hysterosalpingography develop 1–3 days after the procedure.
Early complications of hysterosalpingography include the following conditions:
- Vascular reflux, which occurs due to the penetration of a radiopaque substance into the capillaries and veins of the uterus;
- Lymphatic reflux resulting from the penetration of a radiopaque substance into the fallopian tubes lymphatic vessels or into the broad ligament of the uterus, located in abdominal cavity;
- Perforation of the uterine wall (rupture of the organ wall with an instrument);
- Fallopian tube rupture due to strong pressure pumped liquid;
- Allergic reactions to radiopaque agents.
TO late complications Hysterosalpingography includes the following conditions:
- Exacerbation of chronic infectious process in the pelvic organs;
- Infection of the uterine cavity, fallopian tubes and ovaries with contaminated instruments with the development of an acute infectious and inflammatory process in the pelvis.
TO side effects Hysterosalpingography includes the following body reactions:
- Mild bleeding for 1 to 7 days. If heavy bleeding develops or lasts longer than a week, you should consult a doctor;
- Mild pain in the lower abdomen, similar to menstrual pain. Pain usually appears at the moment of injection of a radiopaque substance into the uterine cavity and can continue throughout the day. If pain is felt longer than 2 days after the procedure, you should consult a doctor;
- When fluid is pumped into the uterine cavity, a woman may experience nausea and dizziness, which will go away after some time;
- After the procedure, the temperature may rise slightly, remaining elevated for 1 – 2 days;
- General malaise for 1–2 days after the procedure.
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:
- Avoid sexual intercourse 1-2 days before the examination.
- 1 week before the examination, do not douche and refuse to use any intimate hygiene products.
- 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 a 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.
Hysterosalpingography is an X-ray examination internal cavities uterus and its tubes after the introduction of a special dye, clearly visible on x-ray thanks 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 benefits ultrasound HSG fallopian tubes can be considered 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 reduce possible negative consequences to a minimum. This procedure is often prescribed as diagnostic test in case of infertility, therefore, even if there is the slightest suspicion of pregnancy, it is categorically 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 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 are possible painful sensations when contrast is administered. 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:
- Pregnancy or even suspicion of possible pregnancy.
- Allergy to any component of the contrast agent.
- Inflammatory or infectious diseases female genital organs, including external ones.
- 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 of fallopian tubes or cavities is usually scanty and goes away 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.
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 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)
- When performing hysterosalpingography, the patient should be protected from pregnancy during the menstrual cycle in which the HSG will be performed;
- 5-7 days before the test, perform a blood, urine and discharge test cervical canal and vaginal flora (without the results of these tests, GHA has no right to conduct);
- in a day HSG procedures a cleansing enema is required immediately before hysterosalpingography - release bladder.
Hysterosalpingography is performed without anesthesia, so if you have increased pain sensitivity or are afraid that hysterosalpingography is 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 insert 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.
Content
Reasons why some women for a long time doesn't work out to get pregnant, they find a lot. One of them is obstruction of the fallopian tubes. To identify such a pathology, special studies are prescribed. Find out how to check the patency of the fallopian tubes. Understand this diagnostic procedure, preparation and consequences.
What is hysterosalpingography
This difficult-to-pronounce concept means a special medical procedure or x-ray. It is carried out to check the condition of the uterus and fallopian tubes, as well as assess their patency. Indications for hysterosalpingography are cases when women cannot conceive a child for a long time or they have already had several miscarriages.
Checking the patency of the fallopian tubes
There are 3 methods used to check the patency of the fallopian tubes. The main one is hysterosalpingography. The procedure involves an x-ray of the fallopian tubes. First, a rubber tip is inserted into the cervix, and through it a thin tube called a cannula is inserted. Through the latter, a coloring substance, often blue, enters inside. Then, using the rays of an X-ray machine, a picture is taken. It shows the structure of the uterine cavity and the tubes extending from it. Other methods for studying these organs include:
Echohysterosalpingography
Assessment of the condition of the fallopian tubes and uterus using ultrasound is carried out using a monitor, and not from an image, as with HSG. Its advantage is the absence of radiation exposure. In addition, echography is also carried out without hospitalization of the patient. The recommended time for the procedure is the day before ovulation. The advantage of this valuable period is that the cervix is relaxed. To prepare for an ultrasound scan, a woman only needs to not eat for 2-3 hours before the procedure. In case of increased gas formation, the gynecologist may prescribe Espumisan, which is taken for 2 days before the test.
To conduct an echography, a woman must pass the following tests: for hepatitis, HIV, syphilis and vaginal microflora. This is necessary to exclude the presence of viruses in the body. During the procedure, patency is indicated by the fact that the contrast medium freely passes through the fallopian tubes and enters the abdominal cavity. Based on reviews from women, we can conclude that after ECHO-HSG there is slight pain that goes away during the day.
X-ray for tubal patency
X-rays or HSG examine the fallopian tubes only in non-pregnant women, because radiation is harmful to the embryo. In such cases, use the previous method, i.e. echography. X-rays are more informative and it is easier to assess the condition of the abdominal organs. The procedure has some disadvantages. Among them are:
- exposure to radiation, albeit in a small dose;
- possible allergic reactions to the contrast agent;
- mechanical damage to the epithelium with subsequent bleeding.
Price of hysterosalpingography
As for the cost of fallopian tube HSG, it depends on the chosen method. IN state clinic any such procedure will be free. In private institutions, the price for x-rays varies from 1500 to 5000 rubles, and for ECHO-HSG - from 5000 to 8000 rubles. There is variation due to the variety of procedures. The upper bar also includes other services:
- consultation with a gynecologist;
- conducting an examination under anesthesia;
- husband's presence at the event.
How to check the patency of pipes
With any method of studying the patency of the fallopian tubes, everything begins with an examination by a gynecologist and the appointment of a test. necessary tests. In addition, the doctor must choose the time when it is best for the patient to undergo the procedure. To avoid inaccurate results, the specialist must be sure that on the day of the examination the woman’s uterus will be in a relaxed state, then the risk of spasms is much less. After passing mandatory tests And proper preparation The procedure itself is carried out to determine the patency of the fallopian tubes.
What tests are needed for HSG
The first on the list of necessary tests are general studies urine, blood and its biochemistry. Tests for syphilis, HIV, and hepatitis are mandatory. You also need to take a vaginal smear to study its microflora. When ordering an x-ray of the fallopian tubes, be sure to do a pregnancy test or take a blood test for hCG. This study is a difference between the preparation process for HSG and ECHO-HSG, because the latter can be used for pregnant women.
Preparation for HSG tubes
This procedure requires special behavior from the woman in the several days before the test date. The latter occurs exclusively on days 5-9 of the menstrual cycle. The preparation for tubal HSG includes the following rules:
- 1-2 days before HSG you need to stop having sexual intercourse.
- During the week before the examination, douching procedures and the use of special means personal hygiene, i.e. tampons.
- The use of vaginal suppositories, sprays or tablets should also be stopped a week before the examination unless approved by the doctor.
- On the day of the examination, it is better to remove excess hair on the external genitalia.
- Before HSG, be sure to empty your bladder and bowels. If there was no stool, then you need to perform a cleansing enema.
Consequences
Even the safety of the HSG procedure does not guarantee the absence of negative consequences. First on the list is allergic reaction for a contrasting composition. This phenomenon is typical for women who have previously had such “answers” during other examinations. Allergies can also occur in patients suffering from bronchial asthma. Even less common are bleeding, infection, or perforation of the uterus.
X-ray radiation does not pose any danger to a woman at all, because its dose of 0.4-5.5 mGy is much lower than that which could lead to tissue damage. In most cases there is pain and minor bleeding go away on their own within a few days. The main thing is to limit yourself from tampons, douching, and visits to the bath, sauna or bathhouse. If the blood does not go away within a couple of days, and is still accompanied by an unpleasant odor, then consult your doctor.
Pregnancy after having your tubes checked
Doctors do not have an exact scientific basis for why pregnancy develops after HSG. Statistics indicate that this procedure actually increases the percentage of a woman’s ability to conceive a child. This happens especially often when testing for tubal patency is carried out using oil contrast agents. For this reason, some delay in menstruation after HSG may indicate not only the stress the woman has endured, but also a possible pregnancy, which you should definitely check.
