12/11/2024
FLUOROSCOPY VERSUS
CONVENTIONAL
BLIND TECHNIQUE FOR HYSTEROSALPINGOGRAPHY
• Importance of HSG : in cases of infertility as a second line investigations
• Incidence of tubal factor in infertility ( 30 % of all infertility ) .
• Associated stigma : Pain and false positive reports .
• Conventional X-Ray – Internal OS is cannulated & dye is blindly injected not knowing the volume of contrast which is going into the uterus.
• The amount of pressure to be applied while injecting the contrast is not known and excessive pressure might lead to immediate filling of uterus & spill into the tubes obscuring the SOL’s / adhesions in the cavity.
• Intravasation of contrast can disiper as tubes.
• Diverticuli ( 2 – 6 % of infertility ) / focal dilatation can be missed as the aim in conventional HSG is to push the contrast blindly.
• Cornual filling defects which are not visualised in conventional HSG cannot be overcomed by negotiating the direction of the contrast which can be done on fluoroscopy guidance.
• Rare chances of perforation uterus can be overcomed
• The amount of contrast can be changed as per the requirement of study ( as seen live on fluoroscopy) & hence can open blocked tubes.
• Better visualization & assessment of the tube character like flimsy tube and rigid tubes which can be congenital of infective.
• Reviewing the images is always an option by fluoroscopy.
• Radiation exposure is much less with fluoroscopy as compared to conventional Xray techniques.
