Hysterosalpingography examination steps

For hysterosalpingography, you should pay attention to choosing the correct time and comply with all the examination principles. The operation should be scheduled 3 to 7 days after the menstruation ends, and you should not have sexual intercourse for five days before the operation to avoid infection.

The first step is to dilate the vagina and expose the cervix. The cervix and fornix are disinfected with iohexol, the cervical catheter is filled with iohexol, the air in the tube is removed, the cervical canal is inserted along the direction of the uterine cavity, and the cervical clamp is tightened so that the conical rubber head of the catheter fits tightly against the cervix to prevent the drug from flowing out.

The second step is that during the hysterosalpingography examination, the patient lies on his back on the X-ray machine operating platform, routinely disinfects the vulva and vagina, then lays a sterile towel, and then checks the position and size of the uterus.

The third step is to observe the contrast agent flowing through the uterine cavity under X-ray fluoroscopy, and slowly inject iodized oil under fluorescent fluoroscopy. The first injection volume is 3~5ml. Observe its entry into the uterus and flow through the fallopian tube. At this time, a picture will be taken and then iodized oil will continue to be pushed in. Continue taking pictures after 5-10 minutes.

Step 4. Take another picture at the same location one day later, and then observe whether there is free iohexol in the abdominal cavity. If both fallopian tubes are blocked, there will be no iodized oil in the pelvic cavity. If there is only a small amount of iohexol, it can be considered that the fallopian tubes are obstructed.

Precautions

Contrast time selection

1. The best time for surgery is 3 to 7 days after the patient's menstruation ends, and sexual intercourse is prohibited 5 days before surgery.

2. Atropine 0.5 mg can be injected within half an hour before the operation to reduce fallopian tube spasm.

3. The patient empties his bladder.

4. Ask whether there is a history of iodine allergy. An iodine allergy test is performed half an hour before imaging. Generally, a skin scratch test is performed by applying 2.5% iodine tincture to the flexor surface of the forearm with a diameter of about 2 to 3 cm. A scratch is made on it and the redness or swelling is observed after 20 minutes. Conjunctival testing or venous testing may also be done. Conjunctival test (conjunctival instillation method): Instill contrast agent into the conjunctiva of one eye. After 15 minutes, observe whether the conjunctiva is congested, red and swollen, and compare it with the side without drug instillation. If so, it is positive. Intravenous test (intravenous injection method): 1 ml of 30% contrast agent of the same batch is injected intravenously. If there is no reaction after 15 minutes, it is negative. If urticaria, sneezing, chest tightness, metallic taste in the mouth, laryngeal edema, etc. occur, it is positive.