What is HSG (Hysterosalpingography)?
Hysterosalpingography, also known as uterine X-ray or medicated uterine X-ray, is a diagnostic method used to examine the uterine and fallopian tubes through radiographic procedures.
HSG is a technique commonly used in infertility cases as it allows the evaluation of the inner structure of the uterus and tubes and patency.
In which situations is HSG performed?
The most common reason for performing HSG is infertility.
- Adhesion in the tubes, obstruction, swelling, liquid filling, etc.
- Uterine polyps, fibroids, anomalies, tumors, etc.
How is HSG done?
The uterus is filled with a liquid contrast material so that the uterus, cervix, and tubes are visible with X-rays. The contrast material goes from the uterus to the tubes and then to the abdominal cavity from the end of the tubes. The flow and distribution of the contrast material in the uterus and tubes are observed under fluoroscopy. Since the contrast agent is given under pressure from the cervix, in some cases, it can also have a therapeutic effect by clearing mucus-like barrier structures in the tubes.
Generally, there is an increase in pregnancy rates in the first 6 months after uterine film is performed.
What is the ideal time for performing HSG?
HSG should be performed within the first 3 days after the end of menstruation due to the following factors;
- In this period, as the intrauterine tissue is thin, and there is no ovulation yet, the probability of pregnancy is low. Thus, possible harm to a newly formed pregnancy is prevented.
- In the following days after menstruation, the intrauterine wall will thicken, hiding possible uterine masses and reducing the scan’s clarity.
- The cervical canal is open during and immediately after the menstrual period. Over time, the cervical canal narrows, making it difficult to place the catheter in this area and enter the contrast material from the inserted catheter.
Note: Women under menopause can perform HSG anytime they feel ready. Any time frame does not apply to them.
Frequently asked questions about HSG
Can HSG be performed during menstruation?
The answer is No. Because during this period, when contrast material is given, the particles that need to be expelled from the uterus together with the contrast material can be transported to the intra-abdominal cavity, which may create a serious infection risk.
What to do before HSG?
It is not necessary to use a drug for preparation before HSG. However, since this procedure is performed using sedation (anaesthesia) at our hospital, it is required not to drink and eat after 24.00 the night before the procedure is prepared. (6-8 hours before HSG)
Note: Anaesthesia time takes approximately 15-20 minutes.
Is HSG painful?
HSG is generally a painless method. However, sometimes mild pain may occur during and after the procedure.
The mild cramping may last anywhere from five minutes after your procedure to a few hours.
What to expect after HSG?
After HSG, the discharge can be sticky and contain small amounts of blood. You may also notice side effects, such as:
- Mild cramps
- An upset stomach or nausea
- A small amount of vaginal bleeding for a day or two
What should be considered after HSG?
- Depending on your comfort, you may resume your everyday activities immediately after your HSG.
- It is not recommended to do heavy work on the same day after HSG.
- Sexual intercourse should be avoided following 3 days after the procedure.
- You can take a shower on the same day after the procedure.
- The usage of a vaginal tampon is not recommended on the day HSG is performed. A pad can be used instead of a vaginal tampon.
- Any environment where infection may occur (pool, sea and sauna) should be avoided for at least 2 days.
- If you have complaints such as severe abdominal pain, fever, or excessive bleeding, it is recommended to consult your gynaecologist.