Having a hysterosalpingogram

A hysterosalpingogram is an X-ray procedure to view the inside of the uterus and fallopian tubes.

The X-ray pictures can show if there are any abnormalities in your uterus, as well as if there are any problems in the fallopian tubes such as a blockage. It can help to explain:

• why you have not been able to get pregnant, if this is something you have been trying to do
• your fallopian tube is blocked if you are having a sterilisation reversal

Alternatives to this procedure would involve a small operation. You will need to discuss this with your referring doctor or gynaecologist.

Information on having a hysterosalpingogram may have been discussed with you at your gynaecology outpatient appointment. 

This procedure will only be done within the first 10 days of your period (menstrual cycle), counting the first day of your period as day 1. This is to ensure that there is no possibility that you are pregnant. Your period will need to have stopped before we can do the procedure. Performing the procedure any earlier may not give us the X-ray images we need and we may need to repeat the procedure.

You must have the scan during the first 10 days of your menstrual cycle (day one being the first day of your period). This reduces the chances of having the scan during pregnancy.

If you do not have regular periods and you have not told your doctor or gynaecologist this, please contact the radiology department on 01709 426307.

Timing the procedure correctly may take a number of months.

• It is important that you telephone the radiology department on 01709 426307 on the first day of your period.
• The radiology department will try to give you a date for the procedure within the 5 days.
• If the procedure cannot be carried out during this monthly cycle, you will then be asked to repeat phoning on the first day of your next period and further periods until a suitable date is arranged.

You may eat and drink normally before the procedure. Please do not wear any jewellery, which may interfere with the examination. You can take any medications that you are prescribed. In some cases, the gynaecology department may have requested further preparation. This will have been discussed with you, if needed.

You may bring someone with you to the appointment but they will not be able to go into the X-ray room with you. They will be asked to wait in the radiology waiting room.

When you arrive at the radiology department, please let reception staff know that you are here.  A nurse or radiographer will collect you from the waiting room and take you to the examination room. The nurse or radiographer will introduce themselves to you and check your details. They will also ask you details of your monthly menstrual cycle. 

Please tell the nurse, radiographer or radiologist (X-ray doctor) if you:

• have any allergies
• have had previous reaction to X-ray contrast media
• are taking any medicines
• if you have had any vaginal infection since being referred for the procedure by the gynaecologist

You will be asked to change into an examination gown and shown where to change.

The person who is performing the procedure will be a specially trained nurse or a radiologist. They will explain the procedure to you and allow you to ask any questions. After being given an explanation of what to expect you will be asked whether you are willing to proceed with the procedure. You will be asked to provide a urine sample. This will be tested as a ‘pregnancy test’. This is to ensure there is no possibility that you are pregnant before we go head with the procedure as X-rays can be harmful in pregnancy to the developing foetus (unborn baby).

You will be asked to lie on an X-ray table, in the position used for a pelvic examination and you are examined as you are for cervical screening. The radiologist or nurse will clean your labia (folds of skin around your vaginal opening) with a mild skin cleaning solution and insert a speculum into your vagina.

A speculum is an instrument that allows the doctor or nurse to see your cervix, which is the opening to the uterus (womb). A catheter (a thin tube) is then placed just inside your cervix. This catheter is used to inject contrast media into your uterus and fallopian tubes. Contrast media is used because it can be easily seen inside the body when an X-ray picture is taken.

Once the X-rays are taken, the instruments are removed from your vagina and you will be given a sanitary towel. The X-ray contrast media is a clear sticky fluid and will drain out of your vagina or be absorbed by your body. Once the procedure is completed, you may get dressed and go home.

Some people feel some discomfort during the procedure at the time when the contrast media is passed into the uterus. This has been described as cramp type period pains. However, the discomfort only lasts for a short period of time and usually feels better when the procedure is complete. If the pain gets worse afterwards, you should contact your GP or the Urgent and Emergency Care Centre (UECC) straight away.

The procedure will take about 15 to 30 minutes, although this may be a little longer in some cases.

You may resume normal activities. The procedure will not affect your ability to drive.

After the procedure, some people experience mild cramp type pains, and spotting of blood from their vagina, for 1 to 2 days. The nurse or radiologist will discuss this with you in more detail before you leave the department.

The results will be sent to the consultant gynaecologist who referred you for the procedure, who will discuss them with you at your next outpatient appointment.

A hysterosalpingogram is a safe, well tolerated procedure, but very rarely, complications may occur. These include infection, or flare up of an old infection and/or bleeding for which antibiotics may need to be prescribed.

Also, very rarely, injury to your uterus may occur which may require surgery.

The risk of allergic reaction to X-Ray contrast media is very rare, but if you develop itching, a skin rash or breathlessness, it is important to go to the Urgent and Emergency Care Centre (UECC) straight away.

Any pain or spotting of blood should subside within 1 to 2 days. If the bleeding lasts more than 2 days, you have worsening pain or develop a fever or chills, you should contact your GP, practice nurse or gynaecologist for advice.

Radiology Department
B level, Rotherham Hospital

Telephone: 01709 426307 - for general enquires about your appointment

Telephone: 01709 427086 - for enquiries about preparation for your examination or to speak to a nurse

You may reach an answering machine. Please leave your contact number, and the nurse will phone you back between the hours of 9am to 5pm, Monday to Friday.