TECHNIQUE

1-The patient must be booked for the examination according to 10-day rule to avoid performing the examination in a pregnant patient or during active menstruation. Hysterosalpingography is an out-patient radiologic procedure under fluoroscopic guidance by a radiologist, with spot films taken at different intervals during the examination. The total fluoroscopic exposure is usually kept to 30 seconds to minimize radiation exposure to the radiologist.
2-As with other types of pelvic examinations, the woman will lie on her back on a radiographic table with her legs sometimes raised in stirrups. The x-ray equipment is placed above the abdomen and the central beam centred at the mid-point of the line drawn from the anterior-superior iliac spine and the pubic symphysis in the mid-line or mid-point between the pubic symphysis and the umbilicus.
3-A bi-valve speculum is inserted into the vagina and opened to expose the cervix. A special hysterosalpingography cannula or a paediatric self retaining catheter is used to inject about 10ml of contrast media piece-meal under fluoroscopic vision by the supervising radiologist.
4-As the contrast media usually urografin which is an ionic contrast media commonly used by radiologists including the author, spreads through reproductive tract the radiologist screens for tubal blockages or other uterine abnormalities fluoroscopically.
5-Commonly, three spot film are taken accompanied by a scout film obtained before instillation of contrast medium. The cost of hysterosalpingography in Nigeria is between N3000 – N10,000.



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