Hysterosalpingography

Contraindications

-pregnancy -pelvic inflammation -vaginal or cervical infection with discharge -Active uterine bleeding -mixture of fluids and contrast media could potentially hinder the diagnostic value of the exam.

Diagnostic

-Determining the size, shape and position of the uterus/ fallopian tubes. -Identifying lesions -Investigating the patency of the uterine tubes. -Assessing causes of infertility. -Assessing structural or functional abnormalities. -Carrying out pre- or post-operative evaluation.

Therapeutic

-During a diagnostic HSG, it may be found that a stenosis is present in the tubes -pressure from the contrast media may clear the stenosis = diagnosis and treatment in one examination.

Structures

-entire pelvic region -speculum & cannula -uterine body cavity, horns and tubes -spill of contrast media in to the peritoneal cavity

Equipment and Contrast Media

-fluoroscopy room -pt in the lithotomy position. -aseptic technique + sterile tray

Procedure

-image intensifier should be centered ~2 inches proximal to the pubic symphysis. -expose the cervix by using the speculum -insert a cannula and attach a tenaculum -contrast injected through a catheter -spot images as required -AP projections are usually sufficient sometimes pt obliqued

Patient Preparation

-outpatient procedure -7-10 days after menstration onset (based on a 28 day cycle) -this protects the oocyte from unnecessary radiation, avoids the possibility of the patient being pregnant, and when most of the endometrium has shed. -Typically, the patient will be required to undergo a bowel cleanse a day before the study and be NPO until the examination is over. -empty her bladder to prevent it from obscuring the reproductive organs -might also be asked to irrigate the vagina and cleanse the perineal area.

Potential Complications

-peritonitis or peritoneal irritation -strict aseptic technique must be followed -rarely haemorrhage.

Uterine Fibroid Embolization (UFE)

-uterine artery embolization -uterine artery is infused with embolic (blocking) agents to reduce the size of and treat uterine fibroids -causes a disruption in the blood supply to the fibroids. -Degeneration of the fibroids may result in resolution of the patient's symptoms.

Hysterosalpingography

-visualization of the female reproductive system -Hystero (uterus) salping (tube) gram (record) -for diagnostic and therapeutic purposes