58340 Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography

Name of the Procedure:

Catheterization and Introduction of Saline or Contrast Material for Saline Infusion Sonohysterography (SIS) or Hysterosalpingography (HSG)

Summary

This procedure involves inserting a catheter through the cervix to introduce saline or contrast material into the uterus. It is used to create detailed images of the uterus and fallopian tubes through ultrasound or X-ray imaging.

Purpose

The procedure helps to diagnose abnormalities in the uterus and fallopian tubes. Physicians use it to identify issues such as uterine fibroids, polyps, scar tissue, or blocked fallopian tubes. The goal is to provide clear imaging to facilitate accurate diagnosis and guide treatment.

Indications

• Infertility evaluation
• Recurrent miscarriages
• Abnormal uterine bleeding
• Suspected uterine abnormalities
• Pre-IVF assessment

Preparation

• Patients may be instructed to take an over-the-counter pain reliever before the procedure to reduce discomfort.
• It is recommended to undergo the procedure just after menstruation ends but before ovulation begins.
• A pregnancy test may be required to ensure the patient is not pregnant.
• Patients may need to avoid using tampons, douching, or having sexual intercourse for 24 hours before the procedure.

Procedure Description

1. The patient lies on the examination table, and a speculum is inserted to visualize the cervix.
2. The cervix is cleaned with an antiseptic solution.
3. A thin catheter is gently inserted through the cervix into the uterine cavity.
4. Saline or contrast material is slowly introduced through the catheter.
5. For SIS, ultrasound imaging is used to visualize the uterine cavity and fallopian tubes.
6. For HSG, X-ray images are taken to observe the flow of the contrast material.
7. The catheter is removed after the imaging is complete.

Duration

The procedure typically takes about 15–30 minutes.

Setting

The procedure is usually performed in a hospital radiology department, an outpatient clinic, or a specialized imaging center.

Personnel

• Gynecologist or Radiologist
• Ultrasound or X-ray Technician
• Nursing staff

Risks and Complications

• Mild cramping or discomfort
• Light spotting or bleeding
• Infection (rare)
• Allergic reaction to contrast material (for HSG)

Benefits

• Provides clear and detailed images of the uterine and fallopian tubes.
• Helps in diagnosing structural abnormalities.
• Assists in planning further treatment for infertility or other uterine issues.
• Non-invasive with quick recovery time.

Recovery

• Patients can resume normal activities shortly after the procedure.
• Some mild cramping or spotting may occur for a day or two.
• Over-the-counter pain relief can be used for discomfort.
• Follow-up appointments may be scheduled to discuss results and next steps.

Alternatives

• Transvaginal ultrasound, which provides imaging without the need for saline or contrast material.
• MRI or CT scan for more detailed imaging but may not provide the same specific information about the uterine cavity and fallopian tubes.
• Diagnostic laparoscopy, which is more invasive but allows for direct visualization and potential treatment of abnormalities.

Patient Experience

During the procedure, patients might feel mild cramping similar to menstrual cramps. Some pressure or discomfort may be experienced when the catheter is inserted and saline or contrast material is introduced. After the procedure, pain is usually minimal, and most patients can return to their regular activities immediately. Pain management strategies include over-the-counter pain relievers and rest.