Step-by-Step Guide to Hysterosalpingography (HSG) Procedure

Hsg procedure proper

A hysterosalpingography (HSG) is a radiologic procedure used to investigate the shape of the uterine cavity and the patency of the fallopian tubes. It is often performed as part of an infertility workup. Here is a step-by-step outline of the HSG procedure:

Preparation:

1. Scheduling: The procedure is usually scheduled after menstruation but before ovulation (typically between days 7 and 10 of the menstrual cycle) to ensure that the patient is not pregnant.
2. Consent: Obtain informed consent from the patient after explaining the procedure, risks, and benefits.
3. Pre-procedure Instructions: The patient may be advised to take a mild pain reliever (like ibuprofen) about an hour before the procedure to minimize discomfort. Some practitioners may also prescribe antibiotics to prevent infection.
4. Empty Bladder: The patient should empty her bladder before the procedure.

Procedure:

1. Positioning: The patient lies on her back on the examination table with her feet in stirrups, similar to a pelvic exam.
2. Speculum Insertion: A speculum is inserted into the vagina to visualize the cervix.
3. Cervical Cleaning: The cervix is cleaned with an antiseptic solution.
4. Catheter Insertion: A thin catheter or cannula is inserted through the cervix into the uterine cavity.
5. Contrast Injection: A radiopaque contrast dye is slowly injected through the catheter. The dye fills the uterine cavity and spills into the fallopian tubes if they are open.
6. Imaging: As the dye is injected, fluoroscopic X-ray images are taken to visualize the flow of the dye through the uterus and fallopian tubes. The radiologist may take several images from different angles.
7. Completion: Once the imaging is complete, the catheter and speculum are removed.

Post-Procedure:

1. Observation: The patient may be observed for a short period to ensure there are no immediate adverse reactions.
2. Discharge Instructions: The patient is given instructions on what to expect post-procedure, such as mild cramping, spotting, or discharge. She is advised to contact her healthcare provider if she experiences severe pain, heavy bleeding, fever, or foul-smelling discharge.
3. Results: The radiologist will analyze the images and provide a report to the referring physician, who will discuss the results with the patient.

Risks and Considerations:

• Infection: There is a small risk of pelvic infection.
• Allergic Reaction: Rarely, patients may have an allergic reaction to the contrast dye.
• Radiation Exposure: The procedure involves a small amount of radiation.
• Discomfort: Some patients may experience cramping or discomfort during and after the procedure.

Follow-Up:

• The patient should follow up with her healthcare provider to discuss the results and any further steps in her treatment or fertility plan.

By following these steps, healthcare providers can ensure that the HSG procedure is performed safely and effectively, providing valuable diagnostic information for the patient.