HSG and Hysteroscopy

Hysterosalpingography
Description

Hysterosalpingograpghy (HSG) is an X-ray method of assessing fallopian tube patency and demonstrating structural abnormalities of the uterine cavity.

Indications

HSG will show whether the fallopian tubes are patent.If not, the area in which the tubes are blocked can be identified. It will not give information concerning the condition of the pelvic, i.e. the presence of peritubular adhesions and/or pelvic distortion which may impair fertility even though the tubes are patent.

Technique

HSG is usually performed without anaesthetic in the X-ray department. A bivalve speculum is used to expose the cervix which is cannulated to enable radiopaque cavity. The procedure is viewed using an image intensifier and recorded on film.

Hysteroscopy
Description and Technique

Hysteroscopy is a method which enables visual examination of the uterine cavity . A hysteroscope is a telescope surrounded by a sheath. It is inserted into the uterine cavity through the cervix with the patient in the lithotomy position and under either local or general anaesthesia.

Indications

Endometrial polyps, fibroids and adhesions within the uterine cavity can be visualized hysteroscopically, together with different types of endometrium, e.g. normal , hyperplastic, atrophic and malignant. It is also possible to use the hysteroscope to take endometrial biopsies, divide adhesions, and remove polyps and misplaced IUCDs. The endometrial lining can be removed using an electrical resection loop or laser in women with menonrrhagia. Submucous fibroids can also be removed in this way.

Complications

Complications of the procedure include perforation of the uterus, infection and fluid overload (e.g. if fluid distension medium is used for endometrial resection.