(Hysterogram; HSG)En Español (Spanish Version)
X-ray examination of the uterus and fallopian tubes after contrast dye is injected through the cervix.
Reasons for Procedure
Hysterosalpingography is used to evaluate the following:
- Uterine tumors
- Intrauterine adhesion
- Developmental disorders
- Obstruction of the fallopian tubes
- Traumatic injury
- Tubal adhesions
- The presence of foreign bodies
© 2008 Nucleus Medical Art, Inc.
Risk Factors for Complications during the Procedure
This procedure should not be done if you:
- Are pregnant
- Have current or past pelvic inflammatory disease (PID)
- Are menstruating or experiencing vaginal bleeding of unknown origin
Factors that increase the risk for complications include:
- Untreated sexually transmitted disease (STD)
- Recently performed dilation and curettage procedure (D & C)
- Vaginal bleeding of unknown cause
- Pre-existing heart or kidney disease
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical and pelvic exam
- Cultures, possibly (especially if you have a history of PID)
In the days leading up to the procedure:
- Schedule the procedure within the first 10 days after your period to precede ovulation and decrease the possibility of disturbing an unknown pregnancy.
- Take any pain medication or antibiotics as ordered by your doctor.
- If instructed to do so by your doctor, take a laxative or enema.
- Have a light meal the night before and do not eat or drink anything after midnight, unless told otherwise by your doctor.
- Wear comfortable clothing.
- Arrange for a ride to and from the procedure.
Possibly a sedative
Description of the Procedure
You will lie on a special x-ray table, called a fluoroscopy table, with your feet in stirrups or pulled up to your chest. The doctor does a pelvic exam to assess the position of the uterus and check for tenderness or inflammation. After inserting a speculum in the vagina, the doctor cleanses the cervix and upper vagina, and then gently inserts a tube that attaches to the cervix.
You are then repositioned and the contrast material is slowly injected through the tube and into the uterus. The doctor watches on a special type of machine called a fluoroscopy and takes x-ray photos (called "films") at different times during the procedure. The table may be tilted or you may be asked to roll from side to side to spread the contrast material and obtain better views. When x-rays of all the areas have been completed, the instruments are removed.
You'll be observed for signs of an allergic reaction and bleeding for about 30 minutes
How Long Will It Take?
The procedure takes about 15 to 45 minutes.
Will It Hurt?
Most patients report some discomfort and cramping during this procedure. If there is a blockage, it may cause more intense pain. Your doctor may order pain or sedating medications to be taken one hour before the procedure to reduce your pain.
- Excessive bleeding
- Adverse reaction to contrast material
- Increased and persistent pain
- Perforation of the uterus
- Injury to a recently fertilized egg
Average Hospital Stay
- Expect some bleeding for a few days after the procedure.
- Use over-the-counter pain medication to relieve discomfort, as needed.
- If an antibiotic has been ordered to prevent infection, take all of the pills that were prescribed.
- Do not stop the medication, unless told otherwise by your doctor.
- Do not douche, use tampons, or engage in sexual intercourse for 48 hours after the procedure.
A radiologist interprets the x-ray films and reports what was found to the doctor who ordered the exam. Your doctor will then make recommendations for treatment.
Call Your Doctor If Any of the Following Occurs
After the test, report any signs or symptoms of infection to your healthcare provider immediately. These may include the following:
- Increased pain
- Heavy vaginal bleeding
- Signs of infection, including fever and chills
- Abdominal pain
- Nausea, vomiting
- Itching, hives, rash
- Difficulty breathing and/or swallowing
American College of Obstetricians and Gynecologists
National Women's Health Information Center
The Society of Obstetricians and Gynaecologists of Canada (SOGC)
Women's Health Matters
Handbook of Diagnostic Tests . 2nd ed. Springhouse Publishing; 1999.
Procedures for Primary Care Physicians . Mosby-Year Book; 1994.
Last reviewed January 2008 by Jeff Andrews, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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