Norm of Hysterosalpingography (Uterosalpingography)
Normal uterine cavity and fallopian tubes.
Usage of Hysterosalpingography (Uterosalpingography)
Identification of adhesions of peritoneum, hydrosalpinx, infertility, pelvic abscess or infection, tubal abnormality, tubal pregnancy, tubal ligation, and uteroileal fistula confirmation.
Description of Hysterosalpingography (Uterosalpingography)
Using serial fluoroscopic radiographs, contrast medium (usually water-soluble diatrizoate or iothalamate) is inserted through the cervix so that the uterus, fallopian tubes, and lumens can be visualized. If laparoscopy is also used, the pelvic peritoneal space can be visualized. The test is used to identify malformations, foreign bodies, trauma, and fallopian-tube patency as well as fistulas or adhesions.
Professional Considerations of Hysterosalpingography (Uterosalpingography)
Consent form IS required.
Allergic reaction to dye (itching, hives, rash, tight feeling in the throat, shortness of breath, bronchospasm, anaphylaxis, death); renal toxicity from contrast medium; uterine perforation; vascular injection of dye; and infection.
Previous allergy to iodine, shellfish, or radiographic dye; renal insufficiency; cervicitis; vaginal bleeding or infection; suspected pregnancy; and cardiopulmonary compromise.
- The test should be performed in the first part of the menstrual cycle.
- Administer cleansing enemas.
- Have emergency equipment readily available.
- The client should disrobe and wear a gown and void just before the procedure.
- Obtain a speculum, a uterine cannula, and dye (diatrizoate or iothalamate).
- Measure and document baseline vital signs.
- See Client and Family Teaching.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
- The client is positioned in the lithotomy position on a tilt table or regular procedure table.
- A speculum is inserted into the vagina.
- Under fluoroscopy, 6–10 mL (in 3-mL increments) of dye is injected into the cervical opening with a uterine cannula to fill the uterine cavity and fallopian tubes. The table is tilted (or the client is moved) to various positions to enable gravitational flow of the dye through the uterus and the fallopian tubes.
- Radiographs are taken 8–24 hours later to help delineate delayed emptying when oily contrast medium is used.
- Assess for signs of gross bleeding or vaginal discharge.
- Monitor vital signs every 15 minutes × 2 and then every 30 minutes × 2.
- Small amounts of bloody vaginal discharge may be present up to 2 days postoperatively.
Client and Family Teaching
- Take the prescribed laxative the night before the procedure. Cleansing enemas will be given before the procedure.
- It is normal to experience cramping, similar to menstrual cramps, and dizziness during the procedure. Taking prostaglandin inhibitors such as ibuprofen before or after the procedure will lessen the cramping discomfort.
- The procedure lasts about 45 minutes.
- Avoid vaginal douching and sexual intercourse for 2 weeks after the procedure.
Factors That Affect Results
- A normal fallopian tube may appear strictured if there is too much traction or if there is tubal spasm.
- Fallopian tubes may appear normal in the presence of adhesions if too much traction is applied.
- See also Rubin's test.