Explaining HSG

by dr. Pande Made Doddy Haryadi, S.Ked.

Hysterosalpingography or HSG is a radiographic examination procedure performed to see the inside of the uterus and oviduct.^[1] HSG at RSIA Puri Bunda is usually performed by doctors to evaluate fertility/infertility and oviducts. This procedure is also often called HSG Pregnancy Program.^[1]

HSG examination is recommended if you experience:

• Fertility

To determine the level of fertility, or fertility disorders caused by blockage of the Fallopian tubes, scarring of the uterus, and abnormal uterine shape, as well as uterine tumors or polyps.

• Egg Duct Blockage

Blockages that occur for example due to infection or the installation of certain contraceptive methods.

• Other problems with the uterus

The occurrence of other problems in the uterus due to abnormal shape, injury, foreign bodies in the uterus, scarring, and polyps in the uterus. ^[2,3]

WHY HSG?

When you are having trouble conceiving, fertility problems, and/or recurrent miscarriages, your doctor will usually recommend an HSG to look for the cause and help in making a diagnosis. This procedure is also closely related to the problem of the Fallopian tubes, if you have undergone Fallopian tube surgery, usually the doctor will recommend HSG again to confirm whether the surgery was successful. ^[2,3]

If you undergo a surgical procedure involving the Fallopian tubes, the doctor will need to confirm the Fallopian tubes post-surgery by performing an HSG procedure. The surgeries include closing or opening of the Fallopian tubes. ^[2,3]

HSG PROCEDURE

When performing the HSG procedure, you will lie down on a special examination site with your knees bent and legs wide open, then a speculum tool is inserted into the vagina to open the vaginal canal so that the inside of the vagina and uterine neck can be seen. The cervix is cleaned with a special soap and a local anesthetic is also given to make you feel more comfortable. ^[2,4,5]

The next action is carried out by means of a small hose or flexible catheter into the neck of the uterus and inserting a special dye into the hose so that it can flow into the oviduct which will be absorbed by the body. The condition of the Fallopian tubes will be seen during a radiology X-ray examination, and you may be asked to adjust your position so that the examination can produce images from various angles. After the X-ray examination, the small tube will be removed and you will be discharged with a prescription for pain medication and antibiotics.^[2,4,5]

For more information or planning to have an HSG examination, you can consult with our obstetrician & gynecologist.

REFERENCES

1. Makwe C, Ugwu A, Sunmonu O, Yusuf-Awesu S, Ani-Ugwu N, Olumakinwa O. Hysterosalpigography findings of female partners of infertile couples attending fertility clinic at Lagos University Teaching Hospital. Pan African Medical Journal. 2021;40.
2. Chalazonitis A, Tzovara I, Laspas F, Porfyridis P, Ptohis N, Tsimitselis G. Hysterosalpingography: Technique and Applications. Current Problems in Diagnostic Radiology. 2009;38(5):199-205.
3. Onwuchekwa C, Oriji V. Hysterosalpingographic (HSG) pattern of infertility in women of reproductive age. Journal of Human Reproductive Sciences. 2017;10(3):178.
4. Karasick S. Hysterosalpingography. Urologic Radiology. 1991;13(1):67-73.
5. Diansih W, Apik. Hysterosalphingography (HSG) Examination Procedure in Infertility Cases at Radiology Installation of Kendal City Hospital. Prodi DIII T. Radiodiagnostics and Radiotherapy Semarang Poltekkes Kemenkes Semarang, 2017.