Hysterosalpingogram (HSG)

What is Hysterosalpingography (HSG)?

Hysterosalpingography, also called uterosalpingography, is an x-ray examination of a woman's uterus and fallopian tubes that uses a special form of x-ray called fluoroscopy and a contrast material.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Fluoroscopy is a special x-ray technique that makes it possible to see internal organs in motion. During a hysterosalpingogram, the uterus and fallopian tubes are filled with a water-soluble contrast material and the radiologist is able to use fluoroscopy to view and assess their anatomy and function.

 

What should I bring to my appointment?

• Your insurance card
• A valid photo ID

Please arrive 15 minutes early to complete registration.

 

How long will my exam take?

HSG procedures are usually completed within 30 minutes.

 

How should I prepare?

The HSG procedure is best performed one week after menstruation but before ovulation to make certain that you are not pregnant during the exam.

This procedure should not be performed if you have an active inflammatory condition. You should notify your referring physician if you have a chronic pelvic infection or an untreated sexually transmitted disease at the time of the procedure.

You should inform your technologist of any medications being taken and if there are any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

You will be asked to remove some of your clothes and to wear a gown during the exam.

 

What happens during the procedure?

The procedure is like a gynecological exam. The patient is positioned on her back on the exam table, with her knees bent or her feet held up with stirrups and a speculum is inserted into the vagina. The cervix is then cleansed, and a catheter is inserted into the cervix. The speculum is removed and the patient is carefully positioned underneath the fluoroscopy camera. A radiologist will then assist the gynecologist to complete the exam. The contrast material then begins to fill the uterine cavity, fallopian tubes and peritoneal cavity through the catheter and fluoroscopic images are taken.

In some cases, if certain abnormalities are encountered, the patient will be asked to rest and wait up to 30 minutes so that a delayed image can be obtained. This delayed image may provide clues to a patient's condition that the original images with contrast material do not. On occasion, an x-ray will be taken the next day to ensure that there is no scarring surrounding the ovaries.

When the procedure is complete, the catheter will be removed and the patient will be allowed to sit up.

When the examination is complete your provider will go over the results with you.

 

What will I experience during and after the procedure?

There may be slight discomfort and cramping when the catheter is placed and the contrast material is injected, but it should not last long. There may also be slight irritation of the peritoneum, the lining of the abdominal cavity, causing generalized lower abdominal pain, but this should also be minimal and not long lasting. Most women experience vaginal spotting for a few days after the examination, which is normal.