Hysterosalpingography is performed by injecting contrast into the uterine cavity and the fallopian tubes through a catheter, and taking X-ray fluoroscopy and radiographs. The test is less invasive and less irritating, and can make accurate judgments on tubal obstruction and has certain therapeutic effects.
Compared with tubal lavage, the imaging can not only understand the condition of the uterine cavity, but also whether there are morphological changes such as deformities, stenosis and adhesions in the fallopian tubes, whereas lavage can only indicate whether the tubes are patent or not.
Indications for hysterosalpingography.
1. Infertility: It is used to understand the cause of primary or secondary infertility, i.e. infertility caused by congenital malformation or tubal incompetence caused by acquired disease, and to show in which section the incompetence lies. In some patients, after hysterosalpingography, the incompetent fallopian tubes can be reopened and conception can occur.
2. History of lower abdominal surgery such as appendectomy, cesarean section; history of pelvic inflammatory disease, chronic appendicitis, peritonitis. Now suffering from endometriosis, etc.
3, to understand the morphology of the uterine cavity, to determine the presence of uterine malformations and their types, the presence of uterine adhesions, submucosal fibroids, endometrial polyps and foreign bodies, etc.
4.Laparoscopy is performed by extra-luminal adhesions of the fallopian tubes, and imaging is performed to further provide the situation in the lumen of the fallopian tubes.
5.For those who are suspected of having incomplete endocervical atresia with a history of multiple midtrimester spontaneous abortions, observe the relaxation of the endocervical opening during the non-pregnancy period.
Contraindications to hysterosalpingography.
1. Acute or subacute inflammation of the internal or external genitalia.
2. Severe systemic diseases that cannot tolerate the procedure.
3, Pregnancy, menstruation.
4.Postpartum, miscarriage, or within 6 weeks after curettage.
5.Iodine allergy.
Step 4: Inject the diffusion agent and observe whether there is free iodophoresis in the pelvis.
Hysterosalpingogram significance.
1. The injected contrast agent has a mechanical flushing effect on the fallopian tubes.
2. The pulling effect on the cervix during contrast may sever some mild adhesions around the fallopian tubes.
3.Iodine oil is viscous and easy to emulsify, which can evenly coat the mucosal surface of the fallopian tubes and can give full play to the local bactericidal effect of iodine.
4.It can improve the mucus environment of the cervical canal.
Treatment of blocked fallopian tubes.
1.Fallopian tube lavage: liquid is injected into the uterine cavity and forced through the fallopian tubes to make the tubes dilated by external force to achieve the purpose of unblocking the fallopian tubes, the liquid contains antibiotics and can eliminate inflammation at the same time.
2.Hysteroscopic tubal lavage + intervention: Observe the fallopian tubes under direct vision of hysteroscope, inject drugs under pressure from the inner mouth of the fallopian tubes, and if intervention is needed, enter the catheter or guidewire into the fallopian tubes through the cervix to directly unblock the fallopian tubes.
3.Chinese medicine: According to Chinese medicine, this disease is caused by internal invasion of heat and toxicity, blocking the meridians and channels; or poor emotions and liver qi; or an obese body with internal production of phlegm and dampness, which leads to poor qi flow, obstruction of cellular veins and stagnation. Patients with blocked fallopian tubes are treated with evidence and herbs are used to unblock the fallopian tubes.
4.Therapeutic method of Chinese medicine: it is the characteristic of our department, mainly including Chinese medicine enema, Chinese medicine package applied externally and so on. The combination of internal and external treatment of Chinese medicine can help to warm the meridians and open the veins, so that the medicine can directly reach the place of the disease, and the combination of internal and external treatment can help to unblock the fallopian tubes and achieve the purpose of conception.
5.Comprehensive treatment: In addition to the above treatment, our department also has warm acupuncture, Chinese medicine ion introduction, medium frequency electric pulse treatment, microwave treatment, infrared irradiation treatment, pelvic exercises and so on.