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Hysterosalpingography (HSG), also known as uterosalpingography, [1] is a radiologic procedure to investigate the shape of the uterine cavity and the shape and patency of the fallopian tubes. It is a special x-ray procedure using dye to look at the womb ( uterus ) and fallopian tubes. [ 2 ]
A petition to grant NHS patients full information about the risks of severe outpatient hysteroscopy pain, and the upfront choice of local anaesthetic, sedation, epidural or general anaesthetic was launched in summer 2018. 'End barbaric NHS hysteroscopies with inadequate pain-relief'. It asks the Secretary of State for Health to ensure that:
They found that about 50% of patients delivered a live baby. The rates for ectopic pregnancy was 2.7%, for miscarriage 34%, and for preterm delivery 20%, while the intrauterine demise rate was 10%. [2] Thus patients with a unicornuate uterus are at a higher risk for pregnancy loss and obstetrical complications.
While a full testing of tubal functions in patients with infertility is not possible, testing of tubal patency is feasible. A hysterosalpingogram will demonstrate that tubes are open when the radioopaque dye spills into the abdominal cavity. Sonography can demonstrate tubal abnormalities such as a hydrosalpinx indicative of tubal occlusion.
Follow-up tests (HSG, hysteroscopy or SHG) are necessary to ensure that adhesions have not reformed. Further surgery may be necessary to restore a normal uterine cavity. [40] According to a recent study among 61 patients, the overall rate of adhesion recurrence was 27.9%. In moderate and severe cases, it is up to 76%. [41] [18] [39]
HSG also has the disadvantage of exposing the patient to radiation from the X-ray that is performed. [2] The radiographic dye, which is iodine-based, can also cause allergic reactions. [22] Though this generally does not occur, there is an increased risk of genital tract infections so patients may be prescribed antibiotics.
For most of the past century patients with tubal infertility due to hydrosalpinx underwent tubal corrective surgery to open up the distally occluded end of the tubes (salpingostomy) and remove adhesions (adhesiolysis). Pregnancy rates tended to be low as the infection process often had permanently damaged the tubes, and in many cases ...
In Essure patients, chronic lower abdominal or pelvic pain occurred in 9% and abnormal bleeding in 16%, compared to 4.5% reporting pain and 10% with abnormal bleeding in the tubal ligation group. It also reported new allergic or hypersensitivity reactions in 22% of patients and no reports of new autoimmune disorders, although blinded ...