Hysterosalpingography is an X-ray examination to look at the uterus and the fallopian tubes. For some, this is part of the investigations for infertility – the inability to have children. Less commonly this is used to investigate for abnormalities in the shape and “structure” of the uterus to see why there are recurrent abortions.

No special preparations are required, unless you have asthma or known allergies. In which case, the indication for the examination is reviewed, since you can develop a reaction to the contrast media used. If your doctor feels the benefits of this procedure will outweigh the risks, then, you may be asked to take prednisolone tablets prior to the examination. This would be 40 mg 12 hours and then, 40mg 2 hours prior to the procedure. Sometimes, if you are unprepared and have a known allergy, then, we may give you an injection of Hydrocortisone 100 mg just prior to the examination.

This examination is best done around the 7^th to 10^th day of your menstrual cycle (from the first day of your menses). It is best to abstain from sex or practise protection methods, once you are scheduled for this examination. This is to ensure that the remote possibility for conception (getting pregnant) is avoided.

What is done during a HSG?

1. For this examination, you will be positioned, as if for a vaginal examination. A vaginal speculum will be inserted to aid visualisation.

2. A small catheter is inserted through the cervix and then, contrast is instilled into the uterus.

3. The contrast is followed to see if they spill out of the fallopian tubes on both sides.

4. Sometimes, the contrast may not flow into the tubes and to ensure this is not due to spasm, we may give you an injection (to relax the muscles of the uterus) or repeat the contrast injection, maintaining pressure.

5. When the necessary radiographs have been taken, the catheter is removed and x-ray films reviewed.

6. You will asked to go to the bathroom to wash up and a sanitary pad will be given to you, so that your underwear will not be stained.

What are some of the potential complications?

1. Some pain, usually lower abdominal may be felt when the contrast spills from the fallopian tubes.

2. Bleeding from vagina. This will manifest as spotting like the end of your menses. This is usually slight and will stop in day or two.

3. Infection

4. Contrast reactions. These are very uncommon and normally will be mild, such as rashes.

What do I do after the HSG?

You will be issued with the post procedure instruction list in some departments

1. Some bleeding from the vagina (like menses) can be expected. However, should the bleeding be profuse, then, you must go and see your gynaecologist immediately. Normally, it should only be spotting, especially after a few hours.

2. You will be provided with a sanitary pad to wear after the procedure.

3. Some patients experience some lower abdominal pain or discomfort. Should these become severe or persist, then again, do consult your gynaecologist.

4. A reaction to the contrast media is uncommon and minor ones such as rashes may occur. In the rare occasion, there may be more serious reactions requiring immediate attention of the doctor. Such reactions normally occur nearly immediately after contrast is instilled but very rarely may be delayed.

5. Contact the Radiology Department if in doubt or see your gynaecologist.

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Last Updated:
Thursday, 21 August, 2003