Unit 2 - Hysterosalpingography, Summaries of Medicine

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Arba Minch University College of Medicine and Health Sciences Department of MRT

Chapter – Two

Special Radiographic Procedure

of

the Female Reproductive

System

Hysterosalpingography

Uterus Anatomy 

Pear shaped organ.



Lies anterior to sigmoid colon & posterior

to bladder.



Average size: 8 x 5 x 3 cm.



Comprised of 3 layers:

 Serosa.  Myometrium.  Endometrium.

The Uterus 

The uterus is subdivided into four

divisions:

(1) the fundus,

(2) the corpus (body),

(3) the isthmus, and

(4) the cervix (neck).

 Orientation  Anteverted, Anteflexed – Normal.  Retroverted, Retroflexed – Abnormal.

 Orientation  (^) The uterine fundus may point anteriorly toward the navel, anteversion , or posteriorly toward the spine, retroversion.  (^) Long axis of the uterus lies horizontally in sagittal plan at 90 degree with the vagina , Anteverted.  (^) The fundus is flexed anteriorly in relation to the cervix with 125 degree , Anteflexed.

 Retroversion & Retroflexion are opposite of anteverted and anteflexed respectively.

Adenexal Anatomy

Fallopian Tubes

Located below fundus.



Average size: 1- 4 mm in diameter and

10-12cm long.



Four segments.



Isthmus.

 Ampulla.

 Infundibulum.

 Fimbriae.

Female Reproductive System

INDICATIONS for HSG  (^) Infertility Assessment - Most Common.  (^) Demonstration of intrauterine pathology :  (^) Lesions demonstrated can include endometrial polyps, uterine fibroids, and intrauterine adhesions.  (^) HSG is also use to diagnose fistulas and congenital defects.  (^) For evaluation of uterine tube after tubal ligation or reconstructive surgery.

Fistulas ??

PATIENT PREPARATION  (^) Proper bowel preparations.  (^) Abstain from i ntercourse b/n booking the appointment and time of exam.  (^) Take a mild pain reliever before the examination.  (^) Empty her bladder immediately before the examination.  (^) Informed consent obtained.

TROLLEY SETTING (HSG SET) Upper (sterile) shelf  (^) Vaginal Speculum.  (^) Vulselum Forceps.  (^) Uterine Sound.  (^) Uterine Canula.  (^) Sterile Gauze.  (^) Sterile Drapes.  (^) Sterile Gloves.  (^) Sponge-Holding Forceps.  (^) 10-ml Syringes.  (^) Basin.  (^) Cotton balls.

Lower(unsterile)

shelf

• (^) Antiseptic Solution.
• (^) Contrast Media.
• (^) Emergency Drugs.
• (^) Obstetric Cream. (e.g. Hibitane 1%)
• (^) Masks.

PROCEDURE  (^) Empty bladder immediately before the examination.  (^) AP scout image may be taken on a 24x30 cm film to look for calcified masses.  (^) Central ray : 5cm superior to the symphysis pubis.