Hysterosalpingography: preparation for the procedure
Hysterosalpingography – known in gynecological practice method for diagnosis of patency of fallopian tubes, detection of anomalies and the presence of tumors in the uterus, the information content of which reaches 85%. The method involves the introduction into the uterus of a contrast material followed by tracking its spread into the fallopian tubes and the abdominal cavity using x-ray installation or of the ultrasound machine.
The reason of existing chronic diseases of the reproductive organs and female infertility can install hysterosalpingography. Preparation for the procedure requires compliance with the recommendations of the gynecologist with the purpose of obtaining accurate results needed to determine further tactics of treatment.
The preparatory period
In spite of the obsolete type of diagnosis, hysterosalpingography remains a popular procedure in gynecological practice. Hysterosalpingography (or HSG) is not only informative method of diagnosis. Introduced under pressure from the contrast agent produces a therapeutic effect, aimed at cleansing the uterine cavity and fallopian pipes from blockages, accumulation of dead cells, mucus and other secretions. Such manipulations allow to remove obstacles to the natural process of fertilization.
To get an accurate result and to prevent possible complications after surgery, preparing for the GHA requires compliance with security measures established by the attending physician before the planned intervention:
- Gynecological examination of vaginal, cervical canal of the uterus – a mandatory procedure that precedes the hysterosalpingography. Clear signs of an acute infectious-inflammatory diseases of the reproductive organs are contraindications to the appointment of diagnostic tests. Only after eliminating all precipitating factors by a physician, a procedure. As a rule, is preceded by hysterosalpingography antibacterial and anti-inflammatory therapy. A course of antibiotics is prescribed after the GHA. At the time of the examination, the doctor shall verify the absence of pregnancy, to exclude the negative influence of ionizing radiation and contrast material on the developing fetus.
- Fence smear for cytological and histological examination allows to assess the degree of purity of the vagina and the presence of atypical cells. At 3 and 4, the purity of the procedure is not carried out until the complete sanitation of the vagina.
- Colposcopy is indicated for cervical disease, can be a contraindication to HSG. When colposcopy smear taken from the cervix for cytological examination. Atypical cells diagnosed in smear of the cervix may indicate cervical dysplasia. Diagnosis of the fallopian tubes is performed only at stage 1 of the disease. The presence of 2,3,4 stages require pre-treatment prior to the study on permeability.
- Blood tests (General KLA, biochemical, and clotting, etc.), the UAC will show the General condition of the organism, the presence of inflammatory processes. Determination of blood group and RH factor is carried out on any day regardless of the date of the hysterosalpingography. A blood test for venereal diseases (syphilis, AIDS, hepatitis) is carried out for 7 – 10 days prior to the proposed study.
- Allergy tests needed to have women who are prone to allergic reactions to the drug components. Contained in the contrast substance iodine has severe allergies. Allergic reaction to iodine-containing preparations and barium the patient is an absolute contraindication for the procedure.
- Preliminary consultation of a gynecologist will need to determine the type of diagnosis, the cost of treatments, method of anesthesia, discussion of emerging additional questions. Soreness during the ongoing manipulations in the reproductive organs are always present, however, the threshold of pain sensitivity all women are different. If the patient is difficult to tolerate the pain, the gynecologist may advise before the procedure (for 2 – 3 hours) to take the pill medication, acute pain syndrome (no-Spa, Analgin, Nurofen). Analgesic effect can also be achieved, if you enter into the cervix Lidocaine.
- Sedative drugs are taken after consultation with your doctor. Medicines plant-based, taken the day of the planned procedure, have a light sedative effect and do not affect the result of the analysis. The choice can be stopped on such preparations as tincture of Valerian, motherwort, notta, Sedavit.
- A cleansing enema is carried out 12 hours before the study to obtain a clear image of the uterus and held in its cavity formations in the picture.
- Before the procedure is necessary to make toilet intimate area, shave the pubic hair. Not recommended the use of drugs administered in vagina, the day of the planned intervention. About all the medicines you are taking should be reported to your doctor is mandatory.
- Directly before the procedure studies it is necessary to remove from the body all the iron things, which can affect the image quality (jewelry, watches, dentures).
- Power correction is aimed at the exclusion of foods contributing to the increased gas-formation, prolonged digestive process, causing the phenomenon of dyspepsia. Recommended to use digestible foods for 2 – 3 days before the hysterosalpingography. On the morning of the procedure, from food refrain. If HSG is performed under General anesthesia, the last meal should be 12 hours before the procedure.
After the hysterosalpingography are vaginal discharge of residues of the injected material. A poet should take care of the sanitary pads and removable underwear.
The observance of the procedure required the recommendations will prevent unpleasant consequences of intervention in the internal organs: perforation of the uterine wall, rupture of the fallopian tubes, infection of pathogenic flora, exacerbation of existing chronic diseases.
The choice of the type and date of diagnosis
Preparation of hysterosalpingography also provides for the selection of the diagnostic study and the exact date.
On what day of cycle is the study, the doctor decides individually depending on the reasons. For the diagnosis of uterine fibroids date doesn’t matter. The only condition is the absence of menstrual flow. For the diagnosis of tubal patency date plan for 5 – 7 days of the menstrual cycle.
The choice of diagnostic tests depends on the indication for its holding:
- menstrual cycle;
- bleeding ambiguous Genesis;
- the suspicion of a malignant tumor, myoma of uterus, hyperplastic process of the endometrium and other diseases;
- clarification of the location of the CPA;
- other States require inspection of the uterine cavity.
Prevention of complications
Manipulation conducted in the reproductive organs, does not eliminate the risk of complications. To minimize the likelihood of side effects of hysterosalpingography, certain rules must be followed:
- Conduct diagnostic study should be a highly qualified specialist.
- You need to inform the doctor about the presence of any chronic inflammatory diseases that may be exacerbated after the hysterosalpingography.
- On the probability of pregnancy should be reported to the physician or radiologist in order to avoid forced interruption.
- Exceeding the permissible radiation dose increases the risk of malignancies, so the choice should be given in favor of modern equipment.
- The adherence of the day, no sex life during the week before hysterosalpingography compliance with the recommendations of a physician significantly reduces the risk of complications.
- Timely revealing of contraindications and their correction.
Hysteroscopy is contraindicated in such conditions:
- acute infectious diseases;
- the exacerbation of chronic disease;
- III and IV degree of purity of the vagina;
- common cervical cancer;
- massive uterine bleeding.
Hysterosalpingography solves the problem of infertility in 30% of cases. Despite the pain and the likelihood of side effects, this kind of diagnosis is still relevant. Diagnostic study allows not only to obtain important information about existing pathologies, but also to restore the lumen of the fallopian tubes.
In the absence of a positive result you need to remember that hysterosalpingography does not solve all the problems of reproductive dysfunction. Rational use of diagnostic tests depends on the indication to his appointment.