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HSG showed no free peritoneal contrast medium spillage on both sides and no hydrosalpin. What does these means?

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Dear doctor, I had a HSG today and the result said Both Fallopian tubes were demonstrated but there was no free peritoneal contrast medium spillage on both sides. There is no hydrosalpinx. Please any further explanation to this and what should I do as I really want to get pregnant. Regards XXXXXXX
Posted Tue, 27 Nov 2012 in Women's Health
 
 
Answered by Dr. Asra Ishtiaq Ahmed 55 minutes later
Hello there.

Thanks for the query.

When there is no spill, it can either be an indication of obstructed fallopian tubes or it can merely be a false positive result (no spill even when the tube is patent).

False positive result is caused by the fallopian tubes going into spasm due to irritation by the XXXXXXX This can be avoided by taking an antispasmodic prior to the procedure or repeating the procedure.

Also it is important to know the site of blockage as treatment depends on it.

An HSG will not identify peritubal adhesions (scars on the outer surface of the fallopian tubes that can cause infertility).

If both the tubes are blocked, then further management will depend upon where the block is.

If it is a fimbrial block(distal block), then there is no way of repairing damaged fallopian tubes since it damages their inner lining (the cilia).
IVF(in vitro fertilization) would be the best option for pregnancy.

If it is a cornual (proximal)block, this could be because of a spasm or because of a mucus plug.
Simple irrigation of the tubes or HSG itself relieves the mucus plug obstruction. This is the reason why some patients conceive after an HSG test itself without any treatment.

Laparoscopic chromopertubation is a diagnostic procedure where a minor surgery is involved. Here a laparoscope is introduced into the abdomen and XXXXXXX is passed into the fallopian tubes through the vagina. Spillage of XXXXXXX is visualized through the laparoscope in the abdominal cavity. It also helps in looking at the external surface of the tubes for peritubal adhesions and infection.
Adhesions can be relieved during the same sitting.

So you can discuss with your doctor about where exactly obstruction in your tube was and if they are planning to take you for a diagnostic laparoscopy. This is because confirmation of HSG findings by this procedure is required to start a treatment.
Also other causes of infertility have to be ruled out before you account your infertility to blocked tubes.

I hope I have answered your query.

take care.
Above answer was peer-reviewed by
 
Follow-up: HSG showed no free peritoneal contrast medium spillage on both sides and no hydrosalpin. What does these means? 15 hours later
Thanks Dr Asra for your answers.
please How would you explain a case where the x-ray done during the HSG shows no blockage at any particular place but still no spillage during the process.

Regards
XXXXXXX
 
 
Answered by Dr. Asra Ishtiaq Ahmed 39 minutes later
Hello XXXXXXX.

Thanks for writing back.

It can be explained by tubal spasm due to irritation by the XXXXXXX Here the tubes get constricted leading to no spillage of XXXXXXX

Pain during HSG can also cause the tubes to go into reflex spasm.

This can be avoided by taking an antispasmodic prior to the procedure or repeating the procedure.

Kindly revert back if any further doubts remain.

Take care.
Above answer was peer-reviewed by
 
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