Hysterosalpingography

What you should know

• Hysterosalpingography (hister-o-salping-GOG-rah-fe), also called HSG, is a procedure to look inside the uterus (womb) and fallopian tubes. An HSG uses an x-ray and a dye to diagnose problems in the female reproductive system. These problems may include tumors, adhesions, blockages, injuries, deformities, and foreign bodies in the uterus and tubes. An HSG is commonly used to know what causes infertility (inability to get pregnant) and frequent miscarriages. It may also be used to check on the fallopian tubes after ligation.
  
  
• During an HSG, caregivers use a special type of x-ray called fluoroscopy. A fluoroscopy shows moving pictures of your cervix, uterus, and fallopian tube while the HSG is being done. These real time movie-like images of the body are shown on a monitor. Dye is injected through the cervix (lower part of uterus) to better outline the uterus and tubes. An HSG usually takes less than one hour and is done 4 to 12 days after your monthly period. With HSG, caregivers may correctly diagnose your health problem and proper treatment may be given.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• Problems may happen during your HSG procedure. Your body may react to the dye which may cause nausea (upset stomach), skin itching, hives, or breathing problems. Tell your caregiver right away if you have any of these symptoms after getting the dye. You could also have an infection or too much bleeding after the procedure. Even after having an HSG, there remains a chance that you will need other tests to check the cause of your health problem.
  
  
• Without having an HSG procedure, you may not know what is causing your medical condition. The signs and symptoms you presently have may continue and become worse. Other serious medical problems you may have will not be diagnosed and treated correctly. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

Getting Ready

The week before your procedure:

• Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using any of your present medicines. These may include aspirin, ibuprofen, or blood thinners.
  
  
• Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.
  
  
• Ask your caregiver how many days before the procedure you need to stop having sexual intercourse (sex).
  
  
• Dye will be used during your procedure to let caregivers see your uterus and fallopian tubes better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may also be allergic to this dye. Tell your caregiver if you are allergic to any of these.
  
  
• You may need to have urine test, ultrasound, and blood tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  
• Your bowel may need to be emptied and cleaned out before the procedure. Caregivers may give you a liquid medicine called an enema. This will be put into your rectum (rear end) to help empty your bowel. Your caregiver will teach you how to do this.
  
  
• You may be given a pill to help you sleep.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include antibiotics, insulin, diabetes pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• You may wear contact lenses on the day of your procedure. Wear socks to help you stay warm.
  
  
• If you are staying in the hospital after your procedure, bring your personal belongings with you. These include your bathrobe, toothbrush, denture cup (if needed), hairbrush, and slippers.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You will need to take your clothes off and change into a hospital gown. Caregivers may give you medicine to make you calm and comfortable during the procedure. During your procedure, feel free to ask for a woman to be present if one is not. You will be asked to lie on an x-ray table and your legs will be put up in stirrups (leg holders). With gloved hands, your caregiver will check your vagina and cervix. Your vagina, cervix, and the area between your legs will be cleaned with soap, water, and iodine solution. Drapes with clean towels will be put over you to keep the procedure area clean.
  
  
• Your caregiver will gently put in a warmed speculum to widen and hold open your vagina. A catheter will then be inserted into the cervix where the dye will be injected. Once the catheter is inserted, the speculum may be removed. An initial x-ray may be taken at this point. Your caregiver will then inject a dye and several x-ray pictures will be taken using fluoroscopy. After the x-rays are taken, the catheter will be removed. The procedure area will again be washed with soap, water, and iodine solution. A sanitary pad will be placed to cover your vaginal area for any bleeding or dye coming out.

After your procedure:

You may stay in bed or sit for a while until you are completely comfortable. Caregivers will watch you closely for any problems. Do not get out of bed or stand up until your caregiver says it is OK. When your caregiver sees that you are OK, your caregiver may allow you to go home. He may also tell you to keep the vaginal pad in place after your procedure. Ask your caregiver for more information about vaginal care, such as changing your sanitary pads.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• You have blood, pus, or foul-smelling odor coming out from your vagina.
  
  
• You have sudden severe abdominal (stomach) or vaginal pain.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.