Hysterosalpingography (HSG), 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.
Fluoroscopy is a special x-ray technique that makes it possible to see internal organs in motion. When the uterus and fallopian tubes are filled with a water-soluble contrast material, the radiologist is able to view and assess their anatomy and function.
HSG is primarily used to examine women who have difficulty becoming pregnant by allowing the radiologist to evaluate the shape and structure of the uterus, the fallopian tubes (tubes leading to the ovaries), and any scarring.
The procedure can be used to investigate repeated miscarriages that result from congenital abnormalities of the uterus and to determine the presence and severity of uterine masses, adhesions/scarring, and fibroids inside the uterus and tubes leading to the ovaries.
Hysterosalpingography is also used to evaluate the fallopian tubes, and to monitor the effects of tubal surgery, including the office based Essure® procedure:
- Blockage of the fallopian tubes due to infection or scarring
- Tubal ligation
- The closure of the fallopian tubes in a sterilization procedure and a sterilization reversal
- The re-opening of the fallopian tubes following a sterilization or disease-related blockage
How is the exam performed?
You will be positioned in a similar fashion to having your pelvic exam at your gynecology office. The radiologist will insert a speculum into your vagina, and clean the cervix with a cleaning solution. They will then introduce a small catheter into the cervical opening and advance it into the uterus. X-ray dye, or contrast, will be injected through the catheter to fill the uterus and fallopian tubes. The radiologist and technologist will take pictures as the contrast advances. The procedure usually takes only minutes to complete.
You may feel pressure and most patients experience mild cramping during and immediately following the procedure. This is usually comparable to menstrual cramping and should subside within a few hours. Most physicians recommend taking ibuprofen 45 minutes prior to the procedure.