What happens during an HSG?
What does the equipment look like?
The equipment typically used for this examination consists of a radiographic table, an x-ray tube and a television-like monitor that is located in the examining room or in a nearby room. When used for viewing images in real time (called fluoroscopy), the image intensifier (which converts x-rays into a video image) is suspended over a table on which the patient lies. When used for taking still pictures, the image is captured either electronically or on film.
How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.
Fluoroscopy uses a continuous or pulsed x-ray beam to create a sequence of images that are projected onto a fluorescent screen, or television-like monitor. When used with an oral contrast material, which clearly defines the area being examined by making it appear bright white, this special x-ray technique makes it possible for the physician to view internal organs in motion. Still images are also captured and stored either on film or electronically on a computer.
Until recently, x-ray images were maintained as hard film copy (much like a photographic negative). Today, most images are digital files that are stored electronically. These stored images are easily accessible and are frequently compared to current x-ray images for diagnosis and disease management.
How is the procedure performed?
This examination is usually done on an outpatient basis.
The patient is positioned on her back on the exam table, with her knees bent or her feet held up with stirrups. A speculum is inserted into the vagina, the cervix is cleansed, and a catheter is then inserted into the cervix. The speculum is removed and the patient is carefully situated underneath the fluoroscopy device. 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, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
The hysterosalpingogram is usually completed within 30 minutes.