Below is some information on the types of procedures that can be performed.
Hysterosalpingogram (HSG)
A hysterosalpingogram (HSG) is an x-ray procedure that is used to view the inside of the uterus or Fallopian tubes. It is often used to see if the Fallopian tubes are partly or fully blocked. It can show if the inside of the uterus is of normal size or shape and whether there any adhesions caused by Asherman’s syndrome. All of these problems can lead to infertility.
What preparation is needed for the examination?
No specific preparation is required. It is best not to attend after a large meal, but there is no requirement for fasting prior to the examination. It is important the examination is performed in the early part of your menstrual cycle after menstruation has ceased. Therefore it is usually recommended to perform the study between the 6th and 10th day of your menstrual cycle. Although the examination is often performed because of difficulty in becoming pregnant, it is important that you are not pregnant at the time of study. Therefore we advise that you should avoid unprotected sexual intercourse after the onset of the menstrual cycle, in that cycle, in which the examination is going to be performed. A pregnancy test will be performed on the day of your examination.
What happens during the examination?
When you arrive in the department, you will register at the reception desk. You will then be taken to change into a gown by a radiographer’s helper or nurse. It is recommended that you empty your bladder prior to examination. You will then be taken into the fluoroscopic (X-ray) room where the Consultant will explain in detail the examination and what it entails. At this time, informed consent for the examination will be obtained. Please ask any questions you may have at this time and the doctor will be only too pleased to answer them. Following this, you will be asked to lie down on the table. The doctor will perform an internal examination of your cervix (similar to the procedure that you have for a cervical smear). When the cervix has been identified a small catheter or instrument will be inserted into the cervical canal and contrast (a liquid that shows up on x-ray) will be injected into the uterine cavity. The cavity will then show up on x-ray and the contrast will then pass into the fallopian tubes and if these are open at the end, will then pass into the peritoneum (abdominal cavity). All these stages are captured on X-ray for analysing. The catheter or instrument is then removed and the procedure is ended. It is Mr Lower’s practice to give everyone a single dose of an antibiotic called azithromicin at the time of the procedure.
The results of the test will be explained to you at the time of the examination.
What to expect afterwards.
You may experience some bleeding after the procedure. This is normal and nothing to worry about and will stop after 24 hours. If not please contact Mr Lower.
If you develop pain, fever or an offensive discharge after the procedure, this is suggestive of an infection. Please contact the office or Mr Lower immediately. If you are unable to do so, please seek urgent medical help either with your own GP or Accident and Emergency Department of your local hospital.
You can usually try to conceive immediately after having had a hysterosalpingogram.
HyCoSy
A HyCoSY is an ultrasound scan in which a contrast medium is used to show whether the fallopian tubes are patent.
The procedure takes approximately 30 minutes. A vaginal ultrasound scan is done first, then a speculum is inserted into the vagina (similar to a smear), so that the cervix (neck of the womb) can be seen. A small soft catheter is then passed into the uterus. A small balloon is then inflated to ensure the catheter remains in the correct place. The contrast medium is injected into the uterine cavity via the catheter and at the same time a vaginal ultrasound scan is done. The passage of the contrast medium can be seen during the ultrasound scan as it passes into the uterus, through the fallopian tubes and into the peritoneal cavity. In this way any blockage in the fallopian tubes can be identified.
The procedure should be performed in the first half of the menstrual cycle but after bleeding has finished (usually between day 6 and 12 of the cycle). It is advisable to refrain from sexual intercourse from the first day of menstrual cycle that the procedure is being performed to ensure that there is no chance of pregnancy.
A pregnancy test will be performed prior to the procedure but a very early pregnancy may not be picked up by routine urine pregnancy test.
Is the procedure painful?
The procedure may be slightly uncomfortable but should not be very painful. The discomfort is similar to mild period pain. The procedure will be abandoned if you experience pain and wish us to stop.
Risks
There may be slight bleeding from the cervix as the catheter is inserted. This should quickly settle.
You may feel some crampy pain during and after the procedure.
Some women feel faint or nauseated after the procedure.
We may not be able to complete the procedure if it is difficult to pass the catheter into the neck of the womb
There is a small risk of infection so a high vaginal swab and Chlamydia screen may be performed to exclude an infection prior to the HyCoSy. A course of antibiotics may also be prescribed to reduce the chance of infection. Symptoms of infection include vaginal discharge and a fever.
What happens after the procedure?
You will be advised of the findings. If any abnormalities are suspected, laparoscopy or hysteroscopy may be recommended in order to investigate further. A member of the clinical team will discuss this with you.
Saline Infusion Sonogram (SIS)
What is it?
Saline infusion sonography involves the instillation of saline into the womb through a catheter passed through the neck of the womb.
The saline creates a contrast so that the inside of the womb cavity can be visualised more clearly.
A vaginal ultrasound scan is done first, then a speculum is inserted into the vagina (similar to a smear), so that the cervix (neck of the womb) can be seen. A small soft catheter is then passed into the uterus and the speculum is removed. Saline is then gently inserted into the uterine cavity via the catheter and at the same time a vaginal ultrasound scan is done. In this way the cavity can usually be clearly seen and examined. In some patients it is not possible to achieve a clear picture and in this case further investigations may be organised.
The procedure is clean but not sterile. You will be advised to take some antibiotics to minimise the risk of infection.
The procedure is usually performed between days 6 to day 13 of your menstrual cycle. We ask you to avoid trying for a pregnancy that cycle.
A pregnancy test will be performed prior to the procedure but a very early pregnancy may not be picked up by routine urine pregnancy test.
After the procedure the saline will pass out of the uterus out of the vagina and after a few minutes you will be able to go home. There is no reason why you may not drive.
Why is it performed?
To identify any conditions within the womb such as polyps, fibroids, adhesions and scar tissue which may adversely affect implantation of the embryo or increase risk of miscarriage
The use of 3 dimensional sonography also helps to assess any variation in the shape of the womb.
Is the procedure painful?
The procedure is uncomfortable but should not be very painful. The procedure will be abandoned if you experience pain and wish us to stop.
Risks
There may be slight bleeding from the cervix as the catheter is inserted. This should quickly settle.
You may feel some crampy pain during and after the procedure.
We may not be able to complete the procedure if it is difficult to pass the catheter into the neck of the womb
There is a small risk of infection.
What happens after the procedure?
You will be advised of the findings. If any conditions are picked up, the implications and management of those conditions will be discussed with you.
Endometrial Biopsy
An endometrial biopsy is the removal of a small piece of tissue from the endometrium, which is the lining of the uterus. This tissue sample can show cell changes due to abnormal tissues or variations in hormone levels.
Taking a small sample of endometrial tissue helps your doctor diagnose certain medical conditions. A biopsy can also check for uterine infections such as endometritis.
We are updating this information …
Hysteroscopy
A hysteroscopy is a procedure in which your doctor inserts a small-diameter device into your uterus. This device has a light and a small camera on the end to allow the doctor to see inside your uterus.
We are updating this information …
Laparoscopy
A laparoscopy, also known as a diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen, as well as other closed spaces, such as the knees. It’s a low-risk, minimally invasive procedure that requires only small incisions.
When an abdominal laparoscopy is performed, a doctor uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
A laparoscopy allows your doctor to see inside your body in real-time, without having to make large incisions. Your doctor can also obtain biopsy samples during this procedure, as well as also perform surgery.
We are updating this information …