Hysterogram

Alternative names
HSG; Uterosalpingography; Hysterosalpingography; Uterotubography

Definition
Hysterosalpingography is an x-ray of the uterus and fallopian tubes for which a contrast dye is injected through the cervix.

How the test is performed

You are instructed to lie on a table in the radiology department and pull your knees to your chest. This is called the lithotomy position. A speculum is then inserted into the vagina, and the cervix is cleaned.

A catheter is inserted through the cervix, and dye is injected, filling the uterus and fallopian tubes. The dye makes the genital organs and their cavities more visible with an x-ray, which is then performed. Any abnormalities are noted.

How to prepare for the test

Fecal material in the bowel can obscure the genital view necessary. For this reason, your health care provider may give you laxatives to take the night before the test. Sometimes an enema or suppositories may be administered the day of the test. Your health care provider may also supply sedatives to help you relax during the procedure. Be prepared to sign a consent form before the test begins and to wear hospital clothing. Often the test will be scheduled in the week following your period, to ensure that you are not pregnant during the test.

Inform your health care provider of any allergic reactions to contrast dry you may have had in the past.

You need not limit any foods or fluids prior to the test.

Infants and children:
The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

     
  • Infant test/procedure preparation (birth to 1 year)  
  • Toddler test/procedure preparation (1 to 3 years)  
  • Preschooler test/procedure preparation (3 to 6 years)  
  • School age test/procedure preparation (6 to 12 years)  
  • Adolescent test/procedure preparation (12 to 18 years)

How the test will feel

The test feels much like a vaginal examination associated with a Pap smear. You may have menstrual-type cramping during or after the test. You may experience some pain if the dye leaks into your abdominal cavity.

Why the test is performed

This test is useful in diagnosing:

     
  • Uterine tumors  
  • Intrauterine adhesion  
  • Developmental disorders  
  • Obstruction of the fallopian tubes  
  • Traumatic injury  
  • Tubal adhesions  
  • The presence of foreign bodies

Normal Values

Normally, all genital structures are present and without abnormality or defect. Contrast dye can normally be seen leaking out the fallopian tubes into the abdominal cavity.

What abnormal results mean

Abnormal results may indicate any of the following:

     
  • Uterine tumors  
  • Intrauterine adhesion  
  • Developmental disorders  
  • Obstruction of the fallopian tubes  
  • Traumatic injury  
  • Tubal adhesions  
  • Presence of foreign bodies  
  • Pregnancy outside the uterus (ectopic pregnancy)  
  • Scarring

What the risks are

     
  • Endometrial infection (endometritis)  
  • Fallopian tube infection (salpingitis)  
  • Perforation of the uterus  
  • Allergic reaction to the contrast dye

Special considerations

This test should not be performed if you have pelvic inflammatory disease (PID) are experiencing unexplained vaginal bleeding, or are currently menstruating.

After the test, report any signs or symptoms of infection to your health care provider immediately. Symptoms may include vaginal discharge, pain, fever, or malaise.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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