Hysterosalpingography (Hysterogram, HSG)

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.

During Procedure

Possibly a sedative

Anesthesia

None

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.

After Procedure

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.

Possible Complications

• Infection
• Excessive bleeding
• Adverse reaction to contrast material
• Increased and persistent pain
• Perforation of the uterus
• Injury to a recently fertilized egg

Average Hospital Stay

None

Postoperative Care

• 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.