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HSG test recommended for remaining tube?

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BeccaBoo
Posts: 3
Joined: Sat Jan 21, 2017 1:04 am

HSG test recommended for remaining tube?

Post by BeccaBoo »

Hi,
I have just had my right Fallopian tube removed following a scan showing an ectopic pregnancy. They said the remaining tube seemed fine from the outside but may be damaged internally. I have read about how HSG tests can be used to check for blockages etc. in tubes. There seems to be evidence to suggest that the test alone can improve fertility / result in pregnancy as it flushes the tubes. I would appreciate a professional opinion on this & advise on who I should approach to request this test? I believe a friend of a friend was given this test via her GP. I have had very little help from my GP & was wondering if I should ask the EPU about this? Any information would be gratefully received x

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: HSG test recommended for remaining tube?

Post by EPT Host 20 »

Dear BeccaBoo,
I am so sorry to hear of your ectopic pregnancy and loss,
I am sorry but I am not medically trained so cannot comment on your specific case.
I believe most investigations are requested via your GP. If you feel you have not been taken seriously by a GP in your practice, request to see a different one.

I have copied our information on HSG testing, I hope this helps,

A Hysterosalpingography (HIS-tur-oh-sal-ping-GOG-ru-fee) HSG test is a valuable test if you have been trying to conceive for a year and are not pregnant if you are under the age of 35, or six months if you are over the age of 35. You should visit your health care provider to discuss this.

(HSG) is a very safe procedure to investigate the shape of the uterine cavity and the shape and patency (the state of not being blocked or obstructed) of the fallopian tubes. The test is an x-ray of the uterus and the fallopian tubes. The doctors inject a special radiographic dye into the uterine cavity through the vagina and cervix which shows up on the x-ray. They then watch to see if the dye moves freely through the uterus and fallopian tubes to look for a block that may be causing fertility problems.

If the fallopian tubes are open, the special dye will fill the tubes and spill out into the abdominal cavity. If the fallopian tubes are full or partially blocked the dye will not flow freely and whether the blockage is located at the junction of the tube and the uterus (proximal) or whether it is at the end of the fallopian tube (distal) can also be determined. The test is not 100% accurate as the fallopian tubes can go into spasm during the test and can appear blocked even though this isn’t the case. The test can also not determine what the internal villi of the tube look like.

The HSG can be painful, so analgesics (pain relief) may be administered before and/or after the procedure to reduce pain. Many doctors will also prescribe an antibiotic, such as Azithromycin, prior to the procedure to reduce the small risk of an infection. The medical professionals prescribe the antibiotics taking the viewpoint that prevention is better than cure and it is better to prevent an infection in your fallopian tubes rather than cure it.

Many women feel emotionally conflicted between wanting the peace of mind of answers versus the fear of catching an infection that could potentially do harm when they have a HSG test.

There is only a 1% chance of getting an infection from a HSG test and, of that 1% chance of infection, only 20% of the 1% who get an infection would need hospitalisation… This means that you have a 99.8% chance of not damaging your fallopian tube and a 0.2% chance of damage.

It would be likely that you would know if you got an infection through symptoms like abnormal vaginal discharge, painful menstrual periods, painful or uncomfortable sexual intercourse, abdominal pain affecting both sides, frequent urination, spotting between periods, pain during ovulation, fever, and/or lower back pain.

People are able to try to conceive again during their next menstrual cycle after a HSG test, unless medical professionals suggest a longer wait time. It has been claimed that pregnancy rates are increased in a cycle when an HSG has been performed.

My doctor says it is too early to have a Hysterosalpingogram (HSG) test, why?
Doctors prefer not to use a HSG test unless they really need to because it is not a 100% accurate test. For example, if the fallopian tubes go into spasm during the test they can appear blocked even though this isn’t the case. The test can also not determine what the internal villi of the tube look like. Furthermore, it is an invasive test and there is a very small (1%) chance that it can cause infection of the fallopian tubes hence their preference to only perform the test when it is unquestionably required.

When an ectopic pregnancy is treated, the remaining tube is typically examined externally and the doctors would usually have told you if they had seen any problems with it at that time. If you would like peace of mind about this you could ask for a post-operative follow up appointment to ask whether they had looked at the condition of your fallopian tubes during the operation.

The examination is a pretty good indicator about the condition of your remaining tube(s) because it looks at:

The fimbriae – The fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae begin to move gently creating a slight vacuum to suck the egg toward the end of the tube it is nearest to (like lots of little fingers waving and drawing the egg towards it).
Whether there are any adhesions (scar tissue).
Whether there is any thickening of the tube.
The shape of the tube.
What is selective salpingography?
Selective salpingography is a fairly new procedure and not available in every centre but is well documented as having good success rates. It is normally done under mild sedation with pain relief.

During a HSG test, a small diameter flexible catheter is threaded inside the HSG catheter and, with the help of the x-ray machine, can be directed right into the opening of the fallopian tube. Once this is done, dye can be introduced directly into the fallopian tube. With this technique, it is possible to demonstrate a normal, patent fallopian tube whose opening may be in spasm. Fallopian tubes with an obstruction can also be opened by the higher pressures which can be achieved with selective salpingography.

Sending much love,
Karen x

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