Hysterosalpingography (HSG) is a radiological technique that allows, by filling the uterus with an opaque contrast through the cervix, to visualize the uterine shape and fallopian tubes through X-rays. This test, although it can be a bit painful, does not require general anaesthesia.
The passage of contrast through the uterine cavity allows drawing its contours to determine if they are regular or not, either due to the presence of adenomyosis, polyps or fibroids or endometrial adhesions. Likewise, contrast allows drawing the uterine shape, which is very useful to rule out the presence of uterine malformations.
Regarding the fallopian tubes, the contrast passage confirms their patency, detecting points of possible obstruction or slow contrast diffusion. When the tubes are intact, the contrast easily passes through them to reach the abdominal cavity. When the tubes are blocked, a slow passage or an accumulation of fluid can be seen, when there is a complete blockage.
HSG is preferably performed in the first phase of the menstrual cycle, just after the end of menstrual bleeding and before ovulation. It is essential to exclude any pelvic infection before it is performed and a vaginal or cervical culture can be performed in the event that there is a risk or suspicion of infection. It is recommended to carry out a prophylactic antibiotic treatment to avoid any possible infection from vaginal germs.
Regarding the discomfort, it is highly variable among patients. As a rule, it can be a relatively painful test, so it is recommended to take painkillers if necessary. Other possible reactions include vasovagal reactions, diffuse abdominal pain or slight vaginal bleeding after its completion.
Contraindications to this technique are pregnancy, active pelvic infection, uterine bleeding, or allergy to iodinated contrast agents.
Patients with an allergy to iodinated contrasts will need other techniques as hysterosonography with saline solution or with non-iodinated contrast media such as hysterosonosalpingography with contrast or Hysterosalpingo-Contrast-Sonograpy (HyCoSy) HYCOSY or with foam or Hysterosalpingo-Foam-Sonographie (HyFoSy).