Hysterosalpingography(HSG) or Uterosalpingography

             Hysterosalpingography(HSG)

                               or

                 Uterosalpingography   

              

Definition 

Hysterosalpingography also known as uterosalpingohraphy is a radiological procedure to investigate the shape of the uterine cavity and shape and patency of the fallopian tubes.

Indications

Infertility

Pelvic infection

Abnormal uterine bleeding

Diagnosis of uterine mass

Contrast

The contrast is used is urographin 60%

Risk Factors

Allergic reaction 

Pain

Bleeding

Leakage of contrast from unsuspected perforation

Intravasation of contrast

Equipments

X Ray unit 

Fluoroscopy with spot film device 

Cotton

Gauze Piece

Sponge holder

Speculum

Anaesthetic jelly

Syringe

Urographin

Surgical gloves and sterile HSG tray.

Preparation

The procedure should be explained to patient before undergoing procedure.

All metallic ornaments should be removed specially in the pelvis region.

The patient is asked to micturate prior to procedure.

The Procedure should be performed during the proliferative phase of the patient’s menstrual cycle between (8th -12th day).

The Patient should be avoid the unprotected sexual intercourse at the time of examination.

Procedure

The patient lies supine on the table and the plain film  (pelvis AP) is taken to detect foreign body.

Then the patient lies in lithotomy position 

Using sterile technique external genital areas are cleaned with betadine.

A vaginal speculum is inserted into the vagina and the cervix is cannulated with cannula and then the speculum is removed.

Then the contrast is injected through the cannula under fluoroscopic guidance and spot films are taken.

The first 5ml of the contrast is injected to fill the uterine cavity and then spot film is taken.

Then the rest of the contrast is injected to fill the fallopian tube and spot film is taken.

Filming

 1. Plain film pelvis AP

After contrast : - 

2. Pelvis AP after 5ml contrast

3. Pelvis AP when rest of the contrast is injected to detect fallopian tubes and spillage.

case 1.  BLOKED TUBE  Lt 

 

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