What exactly is a hysterosalpingogram? What steps are involved? Does it involve any pain? Nora
Hysterosalpingogram (HSG) is an X-ray study of the uterus that uses a special dye visible on X-rays. A series of X-ray images taken as the dye flows into the uterus and through the fallopian tubes helps doctors evaluate the size and shape of the uterine cavity and determine whether the fallopian tubes are open, and sometimes even if there are adhesions near the tubes.
HSG is best scheduled two to three days after the last day of menstrual flow. It is important to ensure that you are not pregnant at the time this study is performed, so if there is any doubt about whether you are pregnant, or if the flow is light, a pregnancy test should be performed beforehand. Many physicians will recommend a dose of antibiotics to reduce the risk of infection and a non-steroidal antiinflammatory agent such as ibuprofen (Advil) or naproxen (Aleve) to minimize cramping.
The doctor begins by inserting a speculum into the vagina. The cervix is wiped with an antiseptic, and a catheter (narrow tube) is inserted into the uterine cavity. There may be a mild cramp with this portion of the procedure. The speculum will be removed, and you will be repositioned on the X-ray table. Your physician or the radiologist will place tension on the uterus to straighten the bend and give a better picture of the uterine cavity. Next, the dye is injected into the uterus through the catheter. This is often associated with cramping. If you are relaxed and in the hands of a gentle physician, the cramping is usually mild. However, if the dye does not flow through the fallopian tubes, additional pressure may be necessary to see if the tubes are really blocked. This can cause more intense discomfort. After the X-ray, you will be asked to remain lying down for another 5 - 10 minutes to allow the cramping to subside. Arrangements should be made with your physicians so that you know when you will be asked to return to discuss the results and determine the next step in your treatment plan. If you experience increasing pain, fever or heavy bleeding after the procedure, you should contact your physician.