Hysterosalpingography

Question 1

what is hysterosalpingography?

Answer 1

• Involves the introduction of contrast medium through a cannula into the uterus.
• Determine size, shape, and position of the uterus and uterine tubes.
• Delineate lesions such as polyps, fibroids, tumors, masses, or fistulous tracts.
• Investigate patency of the uterine tubes in patients who are unable to conceive.

Question 2

indications

Answer 2

• Assessment of uterine tube patency.
• Intrauterine pathology.
• Evaluation of uterine tube following tubal ligation or reconstructive surgery.

Question 3

what is on a hysterosalpingography tray

Answer 3

• Speculum
• Sterile drapes
• Cannula or balloon catheter
• Contrast media—iodinated water soluble
• Lead gloves
• Lead aprons

Question 4

other procedural equipment

Answer 4

• Bright light
• Prep solution, sterile gloves, contrast, lubrication jelly, absorbent pad on table, anti-spasmodic medication
• Fluoroscopy unit
• Stirrups

Question 5

patient prep

Answer 5

• Procedure should be scheduled within 7-10 days following onset of menstruation - endometrium is least congested.
• empty bladder
• NPO 5 hours before exam
• laxative a day prior to exam
• wear hospital gown
• sign consent

Question 6

procedure

Answer 6

• Preliminary scout image made.
• Patient placed in lithotomy position.
• Physician (gynecologist) places speculum into vagina
• Uterine cannula placed in cervix, inserted into uterus.
• Contrast is injected slowly - 10-20ml - fills uterus
• Contrast spills into peritoneal cavity if tubes are patent.
• Absorbed and excreted by way of urinary system within 2 hours

Question 7

What type of contrast agent do we use?

Answer 7

• Currently, iodine-based water-soluble contrast agents are the most frequently used due to their safety profile and effective imaging capabilities.
• Patients should be screened for known allergies to iodinated contrast or iodine prior to procedure.

Question 8

views?

Answer 8

• AP scout
• AP post inejction
• LPO and/or RPO may be requested by doc.

Question 9

considerations

Answer 9

• Collimated
• CR Centered 2” above symphysis pubis
• May do only one view
• Minimize radiation to young patient
• May perform delayed views

Question 10

post care instructions

Answer 10

• may bleed (spotting) for a few days
• cramping should disappear quickly
• blocked tubes may result in pain