Take a picture of the “Road to Life”: salpingography

As the so-called “gold wind and jade dew meet”, the place where human sperm and eggs meet is located in the ampulla of the most spacious fallopian tube. The fallopian tube epithelium is composed of columnar epithelial cells covered with cilia and secretory cells without cilia. As the cilia swing, the egg will be pushed toward the uterine cavity. Therefore, if the fallopian tube is blocked, the “road of life” will be blocked, leading to infertility. In order to increase the chance of natural conception, to identify the cause of infertility in time and take effective treatment measures, the diagnosis of tubal patency is particularly important. The main method for this is salpingography.

Only need to do if there are indications
Hysterosalpingography (HSG) has been in use since the 1950s and is the most extensive inspection method used to understand whether the fallopian tubes are unobstructed, the degree of unobstructedness, and specific obstruction sites. Its method is to use a special thin tube to inject the contrast agent into the fallopian tube through the vagina. After the X-ray imaging, the contrast agent can be clearly displayed in white wherever it goes, so it can be observed from the film whether the fallopian tube is diseased , Deformity, adhesion, obstruction, etc.

At present, hysterosalpingography is widely used in the diagnosis and treatment of infertility. On the one hand, it can diagnose tubal infertility; on the other hand, the syringe needs to be pressurized when the contrast agent is delivered, which may cause mild fallopian tube adhesions. The solution changes smoothly and achieves the purpose of treatment. However, not every woman who is infertile needs a salpingogram. After all, this is an invasive examination and only needs to be done if it is indicated. The indications of hysterosalpingography recommended by various guidelines are: 1. Infertility. Those who live together without contraception and have not been pregnant for more than 1 year, except for ovulation factors, infertility and abnormal semen of the male partner, undergo radiography to determine the obstruction site for further diagnosis and treatment. 2. Determine the category of genital tract malformations.

Both contrast agents have their pros and cons
At present, the main contrast agents used in hysterosalpingography are divided into two types: iodized water and iodized oil.

The iodine solution uses 20 ml of ioverol injection. The advantages are that the contrast agent is cheap, disperses quickly, and the pressure of pushing the drug is relatively small. It can be reviewed 20 minutes after surgery.

The iodized oil uses 10 ml of new super-liquefied iodized oil contrast agent poppy iodized oil, which has the advantages of high iodine content, clearer image development, antispasmodic and pain relief, and local anti-inflammatory effects to improve pelvic immunity. Review in 2 hours.

For the above two methods, patients can choose independently under the advice of doctors.

The best on the 5th to 10th day of menstruation
In clinical practice, in order to avoid receiving radiological examinations without discovering early pregnancy, doctors will recommend that hysterosalpingography be arranged after the end of the menstrual period and before the ovulation period, which is the 5th to 10th day of menstruation. In addition, sexual life should be prohibited 3 days before the examination, and a vaginal discharge test should be performed on the day of the examination; bring sanitary napkins and eat moderate meals on the day of the examination; the body temperature before the operation should not exceed 37.5℃; and remember to rule out the history of contrast agent allergy.

During the examination, X-rays will be received 4 times, but the radiation dose is very low, so there is no need to worry about the problem of excessive radiation; during the imaging process, the most uncomfortable time is when the contrast agent flows through the uterus and fallopian tubes, the pressure generated to open the uterus and fallopian tubes Dredging (with slight obstruction, you can also get through at this time), but the degree is equivalent to dysmenorrhea, and most people can tolerate it. The entire inspection process takes about 10 minutes.

Be aware of postoperative precautions
The results of hysterosalpingography need to be interpreted by a professional doctor, and you should never guess by yourself. If the fallopian tube is blocked by the compression of a gynecological tumor, it is usually removed by surgery. For the obstruction of one side of the fallopian tube caused by non-tumor factors, first determine whether the other fallopian tube can be used. If you are not pregnant for six months without taking any contraceptive measures, you should consider using surgery to dredge the fallopian tube.

Pay attention to strengthen nursing care after the operation. You can take a shower within two weeks, but bathing is prohibited; the same month after the operation is forbidden; vaginal bleeding and slight abdominal pain may occur within one week after the examination. This is generally normal. If there is no other discomfort, it is not necessary To process. Iodine is used as the contrast agent. If the contrast agent shows no problem, you can prepare for pregnancy in the next month; if the contrast agent is iodized oil, you have to contraceptive for 3 months.

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