Posts tagged ‘HSG’

March 11, 2014

HSG and Reducing Anxiety

A health HSG

A healthy HSG

If your doctor orders an HSG (which is much easier to say than hysterosalpingogram) you may have heard stories from friends who have had them – or perhaps you’ve read some (scary) accounts on the internet. These may make you hesitate before scheduling that procedure! But we’re here to tell you, while not a cakewalk, the procedure is really not so bad – and lest you think we speak without knowledge, know that both your blogger docs have had the procedure and survived.

The HSG is one of those tests where it truly is hard to predict the level of discomfort. Experiences are individual – just as some have passing menstrual cramps and others have pain that keeps them in bed, some will say of an HSG, “Meh.” Some will say, “Ugh.” Others may truly experience pain. Your experience may fall anywhere on that spectrum, but there are things you can do to make the experience more comfortable. Communication is, as so often is the case with comfort, key.

In the past we’ve covered the specifics of what goes on in the procedure (here), but to briefly reiterate: an HSG involves injection of a contrast material into the uterus and uses x-ray technology to obtain images of the uterus and the Fallopian or uterine tubes, looking for any potential blockage.

Almost ALL of our patients express post-procedure relief that it wasn’t as bad as they feared. The most common comment – that wasn’t nearly as bad as I thought it would be – wish I hadn’t read all those stories on the internet! This made us think, how can we help to reduce your fear?

An HSG involves a lot of setup. The initial part of the study is about visualizing the cervix and getting the instruments in place so that the contrast material can be injected in your uterus. This is similar in discomfort to your routine pelvic exam- no picnic, but tolerable. The next part of the procedure is filing the uterus with the contrast material and getting our images. This is the part that will produce cramping from contrast filling the uterus, similar to menstrual cramps at their most intense. This part is fairly brief, usually 10 minutes or less. The discomfort ends when the procedure does -so breathe, relax and remember it will all be over in short order.

Now, here are some things you can do to help yourself. First off, ibuprofen is a minor miracle in preventing the cramping. You will be instructed to take some ibuprofen pre-procedure which will make the whole event more tolerable. Next, if you tense up, it is harder to insert the speculum and harder to get the instruments in the right position – so breathe. A few slow, deep breaths can go a long way in relaxing you and your muscles!

It’s helpful to know what your prior experiences are to gauge your potential HSG experience. For women with extremely painful periods, HSGs tend to be more uncomfortable. For women who have had children, HSGs are generally easier to tolerate. If it turns out that your fallopian tubes are blocked, the discomfort will be slightly more intense but will subside fairly quickly once the procedure is complete. And remember, blocked tubes are seen in only a small percentage of women.

If you have difficulty undergoing regular female pelvic exams, please do communicate this. Your radiologist will work with you to help make you more comfortable. Sometimes, it’s as simple as using a different speculum – they come in all shapes, just as we do.

All told, an HSG is an incredibly valuable form of imaging when pregnancy is your goal. We hope this brief discussion will help relieve some of the pre-procedure fright, and we have a feeling you too will be likely to say, “That wasn’t so bad.”

February 20, 2014

A Day in the Life of a Radiologist

LH at station

Let’s take a post to introduce ourselves. This will not be an introduction of us individually but rather a collective introduction. We are radiologists. We are medical doctors with 5 years of specialty training in radiology after medical school. That’s where we could have finished, but many of us did additional subspecialty training in different aspects of radiology like neuroradiology, ultrasound, body imaging, musculoskeletal imaging or breast imaging. So clearly we love schooling, training and practicing in radiology.

It is an exciting field where we have the pleasure and privilege of ‘looking inside’ our patients every day. This is how we take care of you. We carefully and thoughtfully examine imaging studies including CT, MRI, nuclear medicine, ultrasound, X-rays, mammography and fluoroscopy. In radiology we scrutinize images for both normal and abnormal findings in an attempt to detect causes for patients’ symptoms. Our interpretations help the referring doctor or clinician to care for patients. Often, imaging is the key to a diagnosis, from appendicitis to Zenker’s diverticulum.

In addition to looking at images, we perform procedures that are based on imaging – some of these for diagnosis, like barium examinations of the gastrointestinal tract, and many for therapy, like drainage of fluid collections or dilating arteries. Here, we get hands on time with our patients, helping to find problems and to provide solutions.

Admittedly we spend a fair share of time “behind the curtain” in a darkened reading room where images are shared via computer for interpretation. Rest assured we are never bored. Time flies between image interpretations, dictating cases, sharing information with our referring doctors and performing exams such as fluoroscopy or other procedures. Complex cases are the norm, and often require consultation between us as radiologists and your referring doctor. We have a key role in consulting with doctors and patients in ensuring the appropriate imaging study is done in the appropriate manner.

Your radiology test may not involve direct interaction with your radiologist – you will not see us every time. But we will be there, focused on your images to help keep you in your best health.
We love what we do – that’s why we’re here.

August 1, 2013

HSG or Hysterosalpingogram: What to expect before you’re expecting

Hysterosalpingogram, or HSG, is a radiology procedure that uses x-rays to evaluate the uterus and fallopian tubes.  The examination is often ordered for patients experiencing difficulty in getting pregnant, women with prior fallopian tube surgery, or in women planning a reversal of prior tubal ligation.  It can be used to evaluate women who have a developmental or congenital deformity of the shape of the uterus. Some sterilization procedures (like Essure tubes) require an HSG to show the tubes are blocked.

 

Hysterosalpingogram

Hysterosalpingogram

Here’s what you can expect when you schedule an HSG:

 

You will be asked to schedule your appointment between days 7 through 11 of your menstrual cycle. Day 1 of your menstrual cycle is the day you start your period and the exam is done 7 – 11 days following when you are no longer bleeding. This should be a normal period – since the test uses low doses of xrays, we don’t want to do the test if there is a chance you are pregnant. The day of your exam we recommend taking ibuprofen (600 mg) 1 hour prior to your exam to limit menstrual cramping that can result from the procedure.

 

The HSG procedure will require an injection of contrast medication or x-ray contrast dye.  This colorless medication is injected through a small tube, called a catheter, placed in your cervix.  The contrast material will fill your uterine cavity and then flow into your fallopian tubes.  X-ray pictures will be taken during the test.

 

The images produced will be interpreted by the radiologist. Often times, the radiologist can show the images to you right after the test, as many people find them interesting to see. The procedure typically lasts about 10-15 minutes, not counting the setup time.

 

After your HSG is completed, you may experience mild cramping or a small amount of spotting. Most women return to normal activity that day without limitation.

 

Results will be interpreted by the radiologist and a final report will be sent to your provider.