HSG and Fallopian Tube Recanalization
Approximately 25% of women with infertility have some degree of tubal blockage. Dr. Puthoff offers two tests to determine whether fallopian tubes are open and functioning normally. Each of these tests can be completed in about 10 minutes and each serves a slightly different purpose. The test that’s right for you will depend on prior testing as well as your medical and/or surgical history.
Hysterosalpingogram (HSG): This is the most common tubal test and involves injecting an X-ray contrast fluid inside the uterus and watching how it travel through the tubes. During this procedure, Dr. Puthoff uses a small catheter to inject the contrast fluid and this allows him to see if either tube is blocked.
Additionally, the appearance of the tubes and/or the location of the blockage can give Dr. Puthoff very specific information which can help guide treatment decisions. In some cases, a tubal spasm can make it appear as if there is a tubal blockage even if there is not.
Selective salpingogram with fallopian tube recanalization (SS-FTR): This is an advanced type of HSG that allows for a more precise evaluation of the fallopian tubes. During this procedure, Dr. Puthoff uses a specialized catheter system to assess each tube individually and differentiate between a true blockage or a tubal spasm. Additionally, if a blockage is found in either tube near the uterus or in the middle of the tube, Dr. Puthoff can performed a fallopian tube recanalization to reopen the blocked tube with a small flexible wire.
Typically, patients experience mild cramping during an HSG or selective salpingogram. To minimize discomfort, we recommend taking 600mg of ibuprofen two hours before the procedure. If a selective salpingogram is performed, or if a patient has had more significant cramping with an HSG in the past, a local anesthetic can be used to help decrease the discomfort of the procedure. Cramping or spotting may continue for a short time afterwards, but most patients can be expected to go about their normal day following the procedure.
An HSG is used primarily to determine if the fallopian tubes are open or blocked. If a tubal blockage is present, an HSG can usually identify the location of the blockage (near the uterus, in the middle of the tube, or at the end of the tube), which is important as each type of blockage has a different treatment. In some cases, a uterine anomaly (such as a uterine septum or bicornuate uterus) can also be found with an HSG.
A fallopian tube recanalization procedure can be used to reopen blocked tubes if the blockage is near the uterus (proximal tubal obstruction) or in the middle portion of the tube. If the end of tube is blocked, such as is seen with a hydrosalpinx, then another type of surgical procedure would be needed to open and repair the tube instead.
