Fluoroscopy - Hysterosalpingogram (HSG)

What is a Hysterosalpingogram?

A hysterosalpingogram, often referred to as an HSG, is the fluoroscopic evaluation of the uterus and fallopian tubes after the injection of a dye-like contrast material.

What are some common uses of the procedure?

A hysterosalpingogram is done to evaluate patency (openness) of the fallopian tubes.  Patients who undergo this procedure are usually trying to become pregnant.  In some cases, patients are trying to ensure sterility.

How should I prepare for the procedure?

There is no special preparation for a hysterosalpingogram.  Food and fluid intake do not need to be restricted.  In some cases, your physician may prescribe antibiotics as a preventative measure, as well as pain or anxiety medication for those patients who are very nervous about the procedure.

Before exposure to radiation used for this procedure, we must ensure that there is no possibility of pregnancy at the time of your exam.  You must be between day 7 and day 10 of your menstrual cycle.  Between day 1 and day 7, there is still a signigicant amount of blood in the uterus which may cause problems.  Be sure to schedule this exam between days 7 and 10.

Before your exam, you will be asked to change into a gown.

What does the equipment look like?

You will be positioned on an exam table.  Above you will be a box-like structure containing the x-ray tube and fluoroscopic equipment that will send images to a screen in the exam room.

How does the procedure work?

The radiologist monitors the filling and evacuation of the barium in the rectum with a fluoroscope, a device that projects radiographic images in real time onto a screen in the exam room.

How is the procedure performed?

You will be positioned lying down on an exam table.  The radiologist will insert a speculum into the vaginal canal.  In order to prevent infection, an antiseptic will be used to cleanse the cervix.  Next, a small catheter will be inserted into the uterus and a balloon on the end of the catheter will be inflated to hold the catheter in place.  The contrast material will be injected through the catheter, and still images will be obtained.  You may be asked to turn your hips toward each side for more detailed images of the fallopian tubes.

The exam is usually completed within 15 minutes.

What will I experience during the procedure?

Most patients feel a sensation similar to menstrual cramps as the balloon on the tip of the catheter is inflated and when the contrast is injected into the uterus.  Pain tolerance and anxiety levels vary for each patient; however, most patients experience only a minimal amount of discomfort.

Who will interpret the results and how do I get them?

A radiologist will interpret the images, and a signed report will be sent to your physician who will discuss the results with you.