Selective Salpingography & Fallopian Tube Recanalization

A selective salpingogram is a specialized imaging procedure that allows us to evaluate each fallopian tube in detail—often going beyond the information provided by a standard hysterosalpingogram (HSG). When a blockage is found, this test can be combined with fallopian tube recanalization—a minimally invasive technique that opens the tube during the same procedure.

At Veritas Fertility & Surgery, we use this targeted approach for women whose fertility evaluation suggests a possible tubal blockage, helping to both diagnose and treat in a single visit. What’s even better…? We can perform this procedure in the comfort of our office.

HSG and Fallopian Tube Recanalization at Veritas Fertility and Surgery

What is Selective Salpingography?

While a traditional HSG uses X-ray contrast dye to evaluate both fallopian tubes at once, a selective salpingography uses a very small catheter placed directly into the opening of one tube at a time. This allows us to:

  • Evaluate each tube independently, even measuring the pressure it takes to push the contrast dye through the tube
  • Pinpoint the exact location of a blockage
  • Distinguish between a true blockage and a temporary spasm of the tube

Because this test is so precise, it can identify problems that a standard HSG might miss.

What is Fallopian Tube Recanalization?

If the selective salpingography confirms a proximal blockage (near the uterine end of the tube), a recanalization can be performed during the same procedure. Using a tiny, flexible guidewire passed through the catheter, the blockage can be gently cleared, restoring tubal patency and alleviating the blockage in 90-95% of cases.

This technique is:

  • Minimally invasive—no incisions, performed under imaging guidance
  • Quick—recanalization is often completed in minutes once the blockage is identified

Effective—success rates for opening proximal blockages can be very high (90-95%)

HSG-procedure-room

How the Procedure Works

  1. A numbing medication is performed to help minimize any discomfort from the procedure.
  2. A small catheter is placed through the cervix into the uterus.
  3. Under fluoroscopic (real-time X-ray) guidance, the catheter tip is gently guided into the opening of one fallopian tube.
  4. Contrast dye is introduced to evaluate the tube’s appearance and determine if there is a blockage.
  5. If a blockage is seen near in the portion of the tube that is closet to the uterus, a small, flexible guidewire can be advanced to clear it.
  6. The process is repeated for the other tube if needed.

The entire procedure generally takes 15-20 minutes.

Benefits of This Approach

  • More precise diagnosis than a standard HSG
  • Opportunity for treatment during the same session if a blockage is found
  • No surgery required—performed through the cervix
  • Quick recovery—most patients return to normal activities the same day
  • Potential to restore natural fertility without the need for IVF

Next Steps

If your fertility evaluation shows a possible tubal blockage—or if you’ve been told you have a blocked tube after an HSG—selective salpingography with possible recanalization may give you both answers and a chance for immediate treatment.

Contact us today to learn more or to schedule your consultation.

HSG and Fallopian Tube Recanalization at Veritas Fertility and Surgery

FAQs

An HSG evaluates both tubes at the same time, while selective salpingography examines one tube at a time using a tiny catheter at the tubal opening. This allows for more precise diagnosis and the ability to clear a blockage immediately (recanalization) if one is found.

Yes—if the blockage is at the uterine end of the tube (proximal blockage), a flexible guidewire can be used to clear the blockage during the same procedure in most cases.

Most patients are awake and comfortable with the local anesthesia treatment (numbing injection of the cervix). We’ll discuss your comfort options beforehand.

If the procedure is successful and there are no other fertility concerns, many patients are cleared to try in the same cycle as the procedure.

At Veritas Fertility & Surgery, we seek to identify the underlying causes of infertility and other gynecologic issues to provide personalized care tailored to you.

WHAT OUR PATIENTS SAY

“Dr. Puthoff is amazing! He is compassionate, patient, and very intelligent. He seems to really care, and it feels like you’re in good hands. It is reassuring that he is so good at what he does and still allows you to make your own choices.”

“I am very blessed that the Lord brought Dr. Puthoff and his team into my life. His work and the treatment I received made it possible for us to have another child. That is a priceless joy and we couldn’t say thank you enough to Dr. Puthoff.”

“The friendly and welcoming attitude of Dr. Puthoff put me right at ease. He thoroughly explained the procedure and answered all of my questions. I felt extremely confident that he is the right surgeon for my procedure.”

“My husband and I were very pleased with how approachable and comforting Dr. Puthoff was. He took time to listen and to care. We never felt rushed. He gave us hope. That’s what we needed. Thank you Dr. Puthoff for what you do. Your job truly has a lasting impression and gift on your patients.”

“Because of my first visit and the attentive phone calls I have received since, I am confident I am in caring hands for my upcoming surgery. I feel extremely grateful to be getting such amazing care.”

“I always feel involved in my care. Dr. Puthoff has an excellent bedside manner and demonstrates a high level of professionalism.”

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