Hysterosalphingography (HSG)

Netter 2006

HSG remains one of the few techniques which is used to evaluate the patency of fallopian tubes.

It is a simple office procedure done by radiologist using aseptic (sterile) technique which involves insertion of a small sized Foley's catheter into the uterine cavity, followed by introduction of water soluble contrast media into the uterine cavity, thence the patent fallopian tubes and finally into the peritoneal cavity.

The procedure is routinely done during day 4 to day 10 following the cessation of the menses. Patients are required to fast overnight from solid although fluid restriction is not necessary. Patients with documented prior allergy or atopy (e.g. asthma) are routinely premedicated with oral prednisolone with dosage of 40mg 12 hours and 40mg 2 hours prior to the study to avoid contrast adverse reaction. Following the study, pelvic discomfort akin menstrual pain is experienced by some women. Cervical manipulation may induce vasovagal reaction in some, so patients should be accompanied by the partner or some company. If contrast fails to pass through the cornu, IV hyoscine may be administered to induce smooth muscle relaxation. Patients are also advised to bring sanitary pad as spotting due to cervical manipulation is common.

Second picture shown here is an example of a normal HSG where both tubes are normal in caliber and there is spillage of the contrast into the peritoneum indicating patency of the fimbrael ends. Abnormal findings which can be diagnosed via HSG includes blocked tube, hydrosalphinx, abnormality of the uterine cavity (uterine synechiae, endometrial polyp or fibroid) or congenital abnormality of the uterus. All these abnormalities can present as risk factors for infertility.

HSG is provided by this centre via strict appointment basis only.