Preparation for tubal hysterosalpingography. Hysterosalpingography

Hysterosalpingography (another name for metrosalpingography) is an examination method that allows you to see the internal outlines and. There are two types of this procedure: using x-rays or using ultrasound. Classic hysterosalpingography is a radiological examination, that is, it takes a series of x-rays.

Which is better: ultrasound or x-ray?

As mentioned above, there are two types of hysterosalpingography: using ultrasound (another name for sonohysterography) and using x-rays. When comparing these examination methods, it is impossible to select the best one, since each is designed for a specific purpose.

Sonohysterography (HSG with ultrasound) is used mainly to examine the uterine cavity. Using this examination, abnormalities in the development of the uterus, deformation of the uterine cavity, and others can be detected. possible reasons infertility. But an ultrasound examination cannot reliably determine whether the fallopian tubes are passable.

Hysterosalpingography with x-ray is the main method for assessing patency fallopian tubes. Most experts believe that the x-ray method is indispensable if you need to check the fallopian tubes.

In what cases is hysterosalpingography prescribed?

Hysterosalpingography is widely used in the diagnosis of infertility, as it allows you to determine the shape of the uterine cavity and determine whether the fallopian tubes are passable. This type of examination can be prescribed:

• If you suspect obstruction of the fallopian tubes (for example, as a result of adhesions due to and other diseases)
• If there is a suspicion of abnormalities in the structure of the uterus (bicornuate uterus, underdeveloped uterus, septum in the uterus, etc.)
• If you suspect or
• Before ovulation stimulation (for example, with)
• If you suspect

In what cases should hysterosalpingography not be performed?

Contraindications to this procedure are:

• Pregnancy or suspected pregnancy
• Inflammatory diseases of the vagina or uterus
• Severe uterine bleeding

How should you prepare for hysterosalpingography?

Some time before the procedure, you should visit a gynecologist and take a test. This examination will ensure that there is no inflammation in the vagina and cervix that could penetrate the uterus during hysterosalpingography. If inflammation is detected, hysterosalpingography cannot be performed until complete healing. Also, before the examination, you may be prescribed tests for HIV infection, viral hepatitis, etc.

Ask the doctor who will perform the procedure whether there is a need to take a prophylactic antibiotic before hysterosalpingography.

On what day of the menstrual cycle can hysterosalpingography be done?

If you use protection during sex and pregnancy is excluded, then hysterosalpingography can be performed on any day of the cycle, except for the days of menstruation.

If you are not using protection, then it is better to carry out the procedure in the first half of the cycle (immediately after the end of your period), since on these days the probability of pregnancy is the lowest.

Is hysterosalpingography painful?

This procedure is painless, but may seem somewhat uncomfortable or unpleasant. Anesthesia is not required for hysterosalpingography. In order to reduce discomfort during the procedure, the gynecologist may apply a local anesthetic to the cervix.

How is hysterosalpingography performed?

So, you will be asked to sit in a gynecological chair with your legs spread, as during a simple examination. The gynecologist will insert a speculum into the vagina, which will help him see the cervix. After treating the cervix with an antiseptic (to prevent infection into the uterus) and a local anesthetic (to reduce discomfort), the gynecologist will insert a special catheter into the canal (through which a contrast agent will be injected into the uterus) and remove the speculum from the vagina. You will be asked to position yourself under the X-ray machine. After this, a contrast agent will be injected into the uterus through a catheter. During the administration of the substance, a series of x-rays are taken. At the end of the procedure, the catheter will be removed.

What substance is injected into the uterus during hysterosalpingography?

Since the uterus and fallopian tubes are not visible on a simple x-ray, special substances that do not transmit x-rays are used to detect them. These substances are called contrast agents.

For hysterosalpingography, contrast agents Verografin, Urografin, Triombrast, Ultravist and others are used. All these substances contain iodine. These drugs are sterile, so if the procedure is performed correctly, there is a risk of infection of the uterus or other internal organs minimal.

How will you feel after hysterosalpingography?

Discharge: After a hysterosalpingogram, you may have a thick, dark brown discharge that resembles blood. This is where the remains of the contrast agent come out, and possibly pieces of the endometrium (the inner lining of the uterus). Use if discharge occurs.

Pain: Minor pain in the lower abdomen after hysterosalpingography is also possible. They are associated with contractions of the uterus, which may be “irritated” by the procedure. To eliminate pain, you can take a No-shpa tablet.

What complications are possible with hysterosalpingography?

Complications of hysterosalpingography are very rare if the procedure is performed correctly. There is some risk of the following complications:

• An infection that enters the uterus from the vagina or cervix can lead to the development of inflammation of the uterine mucosa (acute or).
• Allergy to contrast agent. If you are allergic to iodine or other substances, be sure to inform your gynecologist.

The risk of damage to the uterus or fallopian tubes is very small, especially if the hysterosalpingography is performed by an experienced gynecologist.

Be sure to contact your doctor if:

• Vaginal discharge does not stop within 2-3 days after the procedure, or has acquired an unpleasant odor
• Body temperature after the procedure increased to 37.5C ​​or higher
• You severe pain lower abdomen
• You have severe weakness, nausea, vomiting after hysterosalpingography

What are the normal results of hysterosalpingography?

Normally, the images reveal a triangular-shaped uterus, from which two fallopian tubes emerge, looking like winding “strings.” At the ends of these “strings” there may be spots of indeterminate shape, which indicate that the contrast agent has passed through the fallopian tube and “poured out” into the abdominal cavity. This is a sign that the fallopian tubes are patent.

If only one thread extends from the triangle, then only one fallopian tube is passable; if there are no threads at all, then both tubes are impassable.

When can you plan a pregnancy after hysterosalpingography?

Since during X-ray hysterosalpingography a contrast agent is injected into the uterus, it is not recommended to plan a pregnancy in the same cycle. You will be able to start conceiving a child in the next menstrual cycle (after the end of your regular period).

The task of hysterosalpingography in gynecology is to determine the condition of the female reproductive organs. The procedure is non-invasive. In rare cases, complications occur after.

Features of the procedure

You can have a hysterosalpingography done at a medical clinic. Diagnostic rules:

The woman lies on her back, bends her knees.

A speculum is inserted into the vagina to separate the walls so that everything inside can be seen.

The cervix is ​​then cleared and local anesthesia is administered.

A catheter with a balloon at the end is inserted into the vagina, which is inflated during hysterosalpingography. The catheter carries the dye into the uterus, fallopian tube, and abdominal cavity. If the fallopian tubes are blocked, the fluid will try to stretch the tube.

After this, the mirror is removed. The woman is placed under an X-ray machine. Images are taken using a fluoroscopy camera.

If there are deviations and anomalies, you will have to wait about 30 minutes to receive a delayed image. They give clues about the presence of pathologies.

Once the images are taken, the catheter is removed.

To check for scarring on the ovaries, an x-ray is taken the next day of the procedure.

Watch a video about how hysterosalpingography is done:

If a potential abnormality is identified on hysterosalpingography of the uterus, treatment begins immediately.

Tubal HSG

Alarming symptoms and complications after hysterosalpingography

Women who undergo hysterosalpingography may experience minor discomfort after the procedure. Unpleasant symptoms include:

slight vaginal bleeding;

mild abdominal pain;

• dizziness, in rare cases fainting.

You cannot use tampons after the examination. It is better to take a shower and avoid sexual intercourse for two days.

HSG of the uterus is considered a non-invasive test with few risks. Some women may develop an infection or have an allergic reaction to the contrast material used during the procedure. You should consult a doctor immediately if you experience:

• severe abdominal pain or cramps;

• smelly vaginal discharge;

  fever or chills

  heavy vaginal bleeding;

  itching, rash or hives;

  difficulty breathing or swallowing.

Benefits of the study

Advantages of hysterosalpingography:

the procedure is less invasive, in most cases it occurs without any complications;

takes 30-45 minutes;

helps diagnose uterine abnormalities and causes of infertility;

opens blocked fallopian tubes;

doesn't have side effects.

Restrictions

The procedure has limitations:

It does not detect abnormalities of the uterine wall, ovaries or pelvic structure.

It does not detect all causes of infertility, such as the inability of a fertilized egg to attach to the uterine wall or an abnormal sperm count.

Alternative Methods

Alternatives to GHA are:

Laparoscopy is a surgical procedure performed under general anesthesia.

Hysteroscopy - gives a detailed view of the inside of the uterus, but does not detect blockages in the fallopian tubes.

Sonohysterography uses ultrasound to look at the inside of the uterus but does not see any abnormalities in the fallopian tube.

This method of studying the condition of the adnexal tubes and uterine body in medical language is called hysterosalpingography(from hystera - uterus (Greek) and salpinx - fallopian tube (Greek)).

The entire examination process consists of filling the body of the uterus and the lumen of the fallopian tubes with a contrast solution, which is delivered into the body via a catheter through the vaginal tract.

After which, using such devices as: X-ray or, the gynecologist examines the condition of the reproductive sphere (the contrast solution makes it possible to determine all kinds of neoplasms, adhesions, local pathological phenomena, etc.), in addition, the method allows you to determine whether the contrast passes through the tubes of the uterus to the area peritoneum.

If it passes, then the patency of the uterine processes is without pathologies, their lumen is unobstructed.

In medical practice, there are two types of HSG - using an X-ray machine and echohysterosalpingoscopy (echo-HSG of the fallopian tubes):

1. When using X-ray equipment the contrast is introduced gradually, in small volumes, and the gynecologist takes a number of pictures one after another.
2. During an ultrasound examination, saline solution is introduced into the uterine cavity., which carries out an auxiliary therapeutic effect, for example, by opening minor adhesions. Largely due to this, after an HSG ultrasound, the desired conception and pregnancy often occurs, in cases where the difficulty was only in the presence of simple pathologies.

Hysterosalpingography is a medical procedure that is performed to examine the structure and contents of the uterine cavity and fallopian tubes and the presence of lumen in the tubes.

Basically, gynecologists use hysterosalpingography to monitor the condition of the genital organs in such representatives of the female population who cannot get pregnant or who have previously undergone several episodes of involuntary termination of pregnancy (miscarriages).

Indications for use

The most important purpose of the hysterosalpingography procedure is to make an accurate diagnosis and get rid of a woman’s infertility.

At the time of the HSG it is established:

• Pipe permeability and determination of the lumen, their structure is the main task of the study;
• Detection of any abnormalities in the uterine body, including anomalies of its structure (bicornuate, saddle-shaped uterus, presence of a septum);
• New formations, cysts, genitourinary and reproductive organs.

In circumstances where a married couple does not conceive within one year, or for much longer periods, hysterosalpingography becomes the very initial examination that every gynecologist recommends.

The absence of lumen of the fallopian tubes occurs due to previously suffered sexually transmitted diseases, inflammation, and congenital abnormalities. Hysterosalpingography also helps the gynecologist assess the physical condition of the uterine body.

Contraindications

Checking the patency of the fallopian tubes

There are three ways in which it is performed.

The main one is hysterosalpingography. This study consists of an X-ray examination of the fallopian tubes.

First, a rubberized tip is inserted into the uterine cervix, and with its help a thin rod called a cannula is inserted. A dye solution (blue) is injected into the cavity through a cannula.

After which, using X-ray radiation, an image is taken. Which displays general state uterine body and tubes.

Other methods of researching the reproductive sphere include:

• Sonohysterosalpingography(similar methods - echohysterosalpingography, sono-, echo-, hydrosonography). This is a method with less severe pain than with HSG of the uterine tubes. The method is carried out by introducing a warm saline solution into the cavity of the uterine cervix using a catheter, and then visually examining the penetration of the solution through an ultrasound machine.
• . As for diagnostic laparoscopy, this is the most inhumane and traumatic method for studying problems in the fallopian tubes. Almost always involves getting rid of adhesions, and for this reason is not performed only for testing. It is carried out by puncturing the abdominal tissues in order to introduce a special instrument that makes it possible to visually examine the organs and tissues of the reproductive system. Carrying out laparoscopy or blowing out the uterine tubes. It is used if a woman is allergic to the contrast component. It is carried out by artificially creating air pressure into the uterus through a soft tube and a pressure gauge.
• Ultrasound diagnostics, which makes it possible to accurately determine the condition of the uterine body and the permeability of the fallopian tubes. Today, this method often becomes initial stage in establishing the tubal root cause of infertility, since ultrasound hysterosalpingography is characterized quite good percentage information content, along with HSG using x-rays (80-91%), and is also acceptable in terms of painful sensations and a less invasive measure. Echohysterosalpingography is performed in a hospital setting, in the initial phase of the menstrual cycle (when menstruation passes). A gynecological catheter is inserted into the uterine cavity, after which a contrast solution of approximately 10 to 20 ml is introduced. (saline solution, liquid glucose, furatsilin, echovist, levovist, etc.). The substance, being in the cavity, provides a visual inspection of the uterine body and makes it possible to evaluate the features of its structure much more definitely. The subsequent introduction of contrast implies its penetration into the pipes, and then into the abdominal location, which may indicate the presence of lumen and patency of the pipes. If there is impermeability of the fallopian tubes, the introduced fluid is not able to penetrate into the abdominal cavity, or accumulates in the tubes. A distinctive feature of ultrasound HSG is its auxiliary therapeutic effect. The fluid injection generated during the procedure destroys minor adhesions located in the pipes, thereby ensuring their permeability. Due to this, conception after tubal HSG becomes a very common result.
• X-ray Peculiarity this method The study consists of injecting contrast into the uterine cavity through a thin tube. In the current realities, only components that dissolve in water are used for fallopian tube HSG: verografin, urotrast, cardiotrust. They have no side effects and are absolutely harmless to the mucous membranes of all organs of the reproductive system. After which 3 x-ray photographs are taken:

HSG of the fallopian tubes under X-ray fixation lasts about 40 minutes. During this examination time, 10-20 ml of contrast liquid is infused into the total volume.

Using X-rays or HSG, the fallopian tubes are studied exclusively in women who are not pregnant, since radiation is always harmful for the embryo. In such circumstances, other possible ways those. echography.

An X-ray examination can provide more information, and it is much easier to assess the current picture of the state of the reproductive organs.

However, the analysis also has some disadvantages. They are expressed in: radiation, albeit in a very small dose; possible allergic reactions to contrast liquid; physical violations of the integrity of the tissue surface, leading to bleeding.

How is the patency of the fallopian tubes checked?

At the time of HSG, the patient is positioned on the couch. When the procedure is carried out using x-rays, the equipment is located above it.

When an ultrasound is performed, the specialist uses a vaginal sensor.

Before inserting the catheter, the doctor applies an antiseptic to the vulva, vagina and cervix.

As usual, HSG is performed without pain, but the woman will still have to feel minor inconveniences: during insertion of the tube into the vaginal cavity and while achieving fluid pressure.

The painful sensation is very similar to the nagging symptoms in the early days of menstruation. The examination is more difficult for nulliparous patients, since their uterine cervix is ​​still dense, which may impede the insertion of the catheter.

Tests for HSG

Prior to the examination, it is required to provide biomaterials (blood, urine) for analysis, and in addition. If pathogenic microorganisms are present, performing HSG can be dangerous, since the disease can “rise” into the uterine body.

Preparation for GHA

Hysterosalpingography is best performed in the first part of the cycle, preferably in the first few days, immediately after the end of menstruation.

IN given time The uterus is still very thin, the cervix is ​​more pliable, for this reason the gynecologist has a greater overview and the introduction of a device for supplying fluid is not difficult.

For this procedure, vaginal discharge must be completed, otherwise blood clots may change the image seen by the specialist.

Preparatory actions for fallopian tube HSG are related to the method by which the test will be performed.

HSG with x-ray

This examination is performed in the first part of the cycle of critical days, while the endometrium is quite thin and does not change the visual image. The most appropriate time is the interval between the first “clean” days immediately after menstruation and ovulation. With a 28-day cycle, this is 6-12 days.

When a referral for HSG is issued in advance, the woman is informed that from the time of the first bleeding until the day of the study, restrictions on sexual intercourse (exclusion) are required.

To carry out the procedure, the patient needs to prepare and undergo the following tests:

• General blood analysis;
• Blood for diseases such as AIDS, jaundice, gonorrhea.
• In addition, a general urine test is provided to determine the level of cleanliness of the vaginal cavity.

The day before the morning when the study is performed, it is necessary to do an enema and empty the intestines using Fortrans.

On the day of the HSG, you need to wash yourself very clean and shave your pubic hair. The examination is carried out in the morning. You cannot eat anything; you are allowed to drink no more than 1 glass of water 1.5 hours before the test.

Preparation for HSG of the fallopian tubes right before the procedure involves the woman emptying her bladder and removing all metal objects and clothing that fall into the X-ray image area.

Consequences and complications

Exacerbations of the condition when performing HSG of the fallopian tubes are very rare.

The most important of which are:

Thus, we can say that side effects from fallopian tube HSG are associated, firstly, with careful preparation for the procedure - establishing all negative indications.

Even the harmlessness of the HSG procedure cannot promise that difficulties and consequences will not arise:

1. The initial line in this list may be an allergic manifestation to contrast components. This occurrence is typical for women who have previously had similar “responses” in other tests. An allergic reaction may also occur in women with severe diseases of the respiratory system (asthma, tuberculosis).
2. Bleeding, disease or damage to the uterus is still uncommon.

X-ray examination does not pose any threat to the patient at all, since its dose is 0.4-5.5 mGy, which is significantly lower than that which could lead to epithelial damage.

Research results

On X-ray images, if there are no adhesions, the outlines of the uterus filled with solution, thin pipe ducts and contrast flowing into the abdominal location are clearly visible. With such an image, a specialist can talk about the permeability of the fallopian tubes.

However, when the liquid stops on any fragment of the pipe, there is an assumption that it is impenetrable.

Based on the results of HSG, it becomes possible to establish not only the presence of a lumen in the fallopian tubes, but also the identification of such pathologies as: polyps in the uterine body, uterine, hydrosalpinx, exerting pressure from the outside onto the tube, or adhesions in the uterus itself.

Even a successfully performed procedure can sometimes mislead specialists. Studies that were carried out to identify the ability to qualitatively detect abnormalities in the condition of the uterus and fallopian tubes are 65%, and the specificity is 80%, which means identifying a certain disease from the probable ones. To examine the condition of the uterine body, hysteroscopy is prescribed as an additional diagnosis.

Pregnancy after the study

Currently, available medical information indicates that hysterosalpingography can actually increase a woman's chances of achieving the long-awaited conception, including those episodes when a contrast fluid containing oils is used for the purpose of performing the procedure.

About certain reasons No one can say such an effect of HSG on the possibility of pregnancy.

If you believe the existing assumptions of gynecologists, then the interaction of the mucous membrane of the reproductive organ with a contrast solution containing oils increases its ability to support the formation of the embryo in the initial trimesters of gestation.

Doctors do not have a definite scientific assumption as to why conception occurs after HSG. Medical data confirm that this manipulation actually increases the percentage of a woman’s ability to become pregnant. This is especially often done in situations where the procedure is performed with the inclusion of oils in the contrast liquid.

Therefore, any follow-up with HSG may indicate not only the stress to which the woman was exposed, but also a possible pregnancy, which must be verified.

Cost of the procedure

Regarding the price of an HSG analysis of the fallopian tubes, it is always related to the method used. In every institution on the balance of the state, any event of this kind will be completely unpaid.

In private clinics and medical centers, the cost of an x-ray - the examination may be in the area from 1500 to 5000 rub. , and on ECHO-HSG – from 5000 to 8000 rub. . There is also a range of prices depending on the classification of a given analysis.

The maximum cost also includes other services:

• specialist consultation;
• carrying out research with painkillers (anesthesia);
• participation of the spouse in the analysis.

Many women wonder what HSG and HSG are, how HSG and HSG of the fallopian tubes are done, how informative and safe this procedure is.

Hysterosalpingography and ultrasound hysterosalpingoscopy are quite often used in gynecological practice. They allow you to safely check the patency and presence of deformations of the internal female genital organs, as well as detect morphological pathology. These procedures are highly informative and have a low incidence of side effects.

Hysterosalpingography (HSG)

What is hysterosalpingography? HSG is a research method that allows you to carefully examine the inner surface of the uterus and fallopian tubes. It provides maximum information for congenital or acquired diseases that are accompanied by changes in the structure of these organs. To do this, a series of x-ray images are taken.

HSG is prescribed if the following diseases and pathologies are suspected:

• congenital anomalies of the development of the internal female genital organs;
• obstruction of the tubes after inflammatory processes or an abortion;
• benign and malignant neoplasms;
• to diagnose tubal infertility in a patient after excluding hormonal causes (including before IVF);
• specific inflammatory processes (tuberculosis, syphilis);
• isthmic-cervical insufficiency;
• a history of ectopic pregnancies;
• spontaneous abortion at any stage of pregnancy;
• pathologies of previous births.

Typically, HSG x-ray or hysteroscopy is performed on patients who have already undergone a complex of preliminary examinations (CBC, OAM, biochemical blood parameters, ultrasound of the pelvic cavity).

Contraindications for the test

HSG during pregnancy in gynecology is strictly prohibited. There is significant evidence of the negative effects of contrast, as well as x-ray radiation, on the fetus. Therefore, the only approved method for diagnosing pathology during this physiological state remains a standard ultrasound of the fallopian tubes. Also, HSG cannot be performed during lactation.

Also, an absolute contraindication to the study is the presence of any allergic reaction to drugs used as contrast. Many guidelines also strongly recommend performing a hypersensitivity test before initiating HSG.

Conducting research is also prohibited under a number of conditions:

• inflammatory processes in the patient’s genital organs;
• the presence of functional kidney or liver failure;
• decompensated cardiovascular diseases ( coronary disease, congenital defects);
• any form of uterine bleeding;
• hormonal imbalances associated with thyroid diseases;
• increased tendency to form blood clots (thrombophilia, thrombophlebitis).

Relative contraindications to tubal HSG include inflammatory changes in general blood tests (leukocytosis, increased BER, increased number of neutrophils) and urine, and bacteriological examination of a vaginal smear.

Ultrasound hysterosalpingoscopy (USGSS)

Ultrasound hysterosalpingoscopy is actually a transvaginal ultrasound examination of the pelvic organs with the introduction of glucose, furatsilin or saline solution into the lumen of the uterus. Ultrasound hysteroscopy provides a dynamic image of the distribution of fluid in the uterine cavity and fallopian tubes.

This method has a number of advantages over GHA. Ultrasound hysterosalpingoscopy does not require the administration of contrast, which eliminates the possibility of allergic reactions and also reduces the list of contraindications. Also, this method does not expose the patient’s body to x-ray radiation. With ECHO HSG of the fallopian tubes, complaints of pain and a feeling of heaviness are less common.

Ultrasound hysterosalpingography for this large quantities advantages, also has its disadvantages. It visualizes the organ cavity worse, which reduces the informativeness of the diagnosis. The quality of the results depends on the qualifications of the diagnostician, which, in the presence of errors, has Negative consequences in future.

Preparing for the study

Many patients are concerned about the question of how to prepare for HSG and USGSS so that the results of the study are as informative as possible. After prescribing the procedure, the attending physician carefully informs all of them about this.

Contrasting the uterus and fallopian tubes

Preparation for tubal HSG and hysterosalpingoscopy consists of several important steps. First, the gynecologist needs to conduct a general examination of the state of the main functional systems of the body. Additionally, the patient is tested for some common infectious diseases (AIDS, syphilis, gonorrhea). In the evening the day before the test, it is also recommended to perform a cleansing enema to remove feces from the intestines.

The study is carried out on days 5-10 of the menstrual cycle. This allows, on the one hand, to almost completely eliminate pregnancy in the patient, and on the other, a thinner endometrium contributes to less intensity of discomfort during the procedure and better visualization of organs.

On the day of an HSG or ultrasound to determine the patency of the fallopian tubes, it is necessary to thoroughly clean the patient’s external genitalia, as well as shave the pubic hair, as it may interfere with the examination.

The HSG procedure in gynecology involves the patient emptying her bladder immediately before the start of the study. It is also necessary to remove all metal jewelry and items of clothing in the genital and pelvic area. Hysteroscopy, on the contrary, requires that the patient have a full bladder before the examination.

Research methodology

X-ray examination of pipes for patency is carried out in a special room. The patient takes a place on a standard table for gynecological interventions. Both HSG and ultrasound examination of the patency of the fallopian tubes begin with an external examination by a specialist of the woman’s external genitalia, vagina and cervix using a gynecological speculum. After this, an antiseptic treatment is carried out and a catheter is inserted into the cervical canal through which a contrast agent is injected.

Introduction of saline solution into the uterine cavity and USGSS

The first image is taken after the injection of 2-3 ml of contrast. After a short period of time, a second portion of the substance is supplied, which facilitates its penetration into the lumen of the fallopian tubes. It is at this moment that the second photo is taken. With normal tubal patency, some contrast material enters the abdominal cavity. If necessary, a third picture is taken after 20-30 minutes.

Use of medications during the procedure

HSG is considered an almost painless procedure, as is ultrasound hysterosalpingoscopy. Therefore, anesthesia is used only for severe pain in a very small proportion of patients.

In some clinics, before the study, antispasmodics (drotaverine, papaverine) are additionally administered, which allows you to relax the cervix and avoid problems with inserting a catheter into the uterine cavity.

Side effects during HSG

Checking the patency of the fallopian tubes using contrast may be accompanied by the development of side effects, although in general the procedure is considered absolutely safe. About a third of patients note discomfort in the abdominal area, which sometimes turns into nagging or aching pain.

The most dangerous complication of the procedure is the development of local and general allergic reactions of varying severity. Cases of anaphylactic shock with systemic hemodynamic disturbances have been described. Therefore, medical personnel approach this procedure with special attention and caution.

If the research methodology is violated, traumatic damage to the uterine mucosa by the catheter is possible, which is clinically manifested by bleeding from the vagina.

Research results

Hysteroscopy allows for a thorough examination of the uterine cavity and fallopian (uterine) tubes. The radiologist obtains high-quality images of the anatomical structure of the patient’s internal genital organs. They can be used to visualize signs of congenital malformations, the consequences of inflammatory processes, and the presence of tumors. Hysterosalpingography cannot determine the type of oncological process; therefore, if it is detected, a biopsy with cytological examination is usually performed. Ultrasound hysterosalpingoscopy also provides information about the condition of the uterine walls and the presence of pathology in the myometrium.

Hysterosalpingography remains the leading and simple method diagnosing the causes of tubal infertility and anomalies in the development of the internal genital organs in women. Along with it, ultrasound hysteroscopy is performed, which is characterized by less information content and greater subjectivity of the results, but has fewer contraindications.

A transcript of the results is usually sent to the attending gynecologist or given to the patient immediately after the study. They not only help to assess the patency of the fallopian tubes using ultrasound, but also determine further tactics for diagnosing and treating the patient.