Hysterosalpingography (HSG), or uterine film in Turkish, is a method used in gynecology to examine the structural and functional properties of the uterus and its channels.
It is one of the basic tests requested in the evaluation of infertility. In addition, if menstrual bleeding stops or decreases significantly after an intervention to the cervix or uterus (such as abortion), it is necessary to evaluate a possible obstruction in the cervical canal or a possible adhesion in the uterus (Asherman syndrome), and to determine whether there is a congenital developmental defect in the uterus in case of recurrent miscarriages (see below). It is also widely used to determine the picture on the left - septate uterus).
When is the uterine film taken?
A detailed gynecological evaluation is performed before HSG application. If signs of infection (inflammation) are detected during this evaluation, the procedure is postponed until the infection is treated. In principle, HSG is applied within a few days after the end of menstrual bleeding. The reason for this is, on the one hand, to prevent problems caused by menstrual bleeding from the uterus filling the tubes and from there into the abdominal cavity, and on the other hand, to prevent any harm to a possible pregnancy in the uterus. Because, in very rare cases, a woman who is being evaluated for inability to become pregnant may accidentally become pregnant that month.
How is a uterine film taken?
A uterine film is performed by a Gynecologist and Obstetrician. and are applied together by the Radiology Specialist or Technician. While in the gynecological examination position, an instrument is inserted into the vagina to view the cervix. Then, another device called a cannula is inserted into the uterus. Contrast material (medicated substance) is administered by applying pressure in several stages through the syringe attached to the cannula. This liquid gives a white appearance to the x-ray film as it does not transmit light. During fluid administration, x-rays are either taken at regular intervals or the passage of fluid through the screen is constantly monitored and recorded using a method called fluoroscopy. In this way, the internal structure of the uterus, whether the channels are open or not, and their structure are evaluated. Although HSG is a technique performed with the help of x-rays, the dose of radiation given is not high.
Is uterine X-ray a painful procedure?
There is a common belief among women that uterine X-rays are very painful. However, when performed gently and carefully, HSG is actually a procedure that creates a slight stinging and stretching sensation in the abdomen and is less painful than tolerable. For this reason, the procedure is generally not performed under general anesthesia. However, it can also be performed under anesthesia in women who have a low pain threshold and are very sensitive, who can hardly tolerate even a normal gynecological examination. For the majority of patients, a simple painkiller taken 30-60 minutes before the procedure ensures that the procedure is comfortable and trouble-free. There is a slight increase in spontaneous pregnancies after HSG withdrawal. The reason for this is explained as the slight adhesion in the tubes being opened due to the medication given under pressure. Additionally, if there is a microbial event as a cause of infertility, the antimicrobial properties of the medication given may also be therapeutic. Therefore, it is not surprising that a couple who has been suffering from infertility problems for a long time becomes pregnant spontaneously after HSG.
Are there any harmful side effects of uterine film? reaction may occur. For this reason, new types of drugs with extremely low allergy potential should be preferred instead of old types of drugs. The most common complication is infection and occurs in one in every 100 patients. There is no need to use antibiotics before or after the procedure to prevent infection. Antibiotic prophylaxis is given before the procedure as a precaution only for those with heart valve disease.
After the Uterine Film is taken;
There may be spotting or a small amount of vaginal bleeding. If the bleeding is heavy or lasts longer than a few days, you should definitely call your doctor. Additionally, mild or moderate back and groin pain may occur after the extraction. If the pain increases or a fever occurs, this may be a sign of an early infection, and be sure to call your doctor. Since the cervix is slightly strained during the procedure, it is dangerous to take a bath, have sexual intercourse and use vaginal tampons for 48 hours after HSG.
R What will happen if one or both of the tubes are closed in the ahim film?
First of all, it is necessary to know that although HSG is a very useful and basic examination, it may not always fully reflect the truth. In other words, just because the tubes appear closed on the uterine film does not always mean that they are actually closed. Due to the discomfort and pain felt by some women with low pain threshold during the procedure and sometimes as a reaction to the medication given, spasm in the canals may cause the medication not to pass through the tubes and one or both tubes may be mistakenly interpreted as closed. However, when evaluating a uterine film, an experienced Gynecologist and Obstetrician can often distinguish the failure of the drug to pass through the tubes due to spasm from a truly blocked uterine film. For this reason, we recommend that a muscle relaxant, called an antispasmodic, be administered before the uterine film. Sometimes, tubes that are considered closed on the film can also be seen to be open during Laparoscopy. Therefore, if the tubes are thought to be closed and an in vitro fertilization decision is to be made, it may be more logical to perform Laparoscopy beforehand. Because in laparoscopic evaluation, it may be revealed that the tubes are actually open and it can be understood that the couple will benefit from the insemination method. In addition, during Laparoscopy, the problem in the tubes can be revealed more clearly and treated immediately, and the channels can be opened with the necessary intervention. Of course, this may not be valid in every case, and it may turn out that the couple will only benefit from in vitro fertilization treatment after laparoscopy.
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