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Hysterosalpingoconstrastsonography (HyCoSy)

A small amount of fluid (contrast material - ExEm foam) is injected into the uterus through a fine tube and observed as it flows through the open Fallopian tubes.

What is the main reason for having this examination?

  • Investigation of sub-fertility

You should not have the procedure if you are pregnant or may be pregnant at the time of the examination or you have acute pelvic infection or unexplained pelvic tenderness or other symptoms which may be due to pelvic inflammatory disease.

This technique is used to detect blockage of the Fallopian tubes.  It can also be used to assess the uterine cavity shape, though plain 3-D ultrasound or saline-infusion sonography is usually preferred for this purpose.  HyCoSy is an alternative to the x-ray procedure called hysterosalpingogram (HSG).  Unlike with HSG, HyCoSy uses no radiation or iodinated contrast material.

How is the Procedure performed?

On the day of the procedure a transabdominal and/or transvaginal ultrasound of the pelvis may be performed immediately prior to the procedure. A speculum will be placed in the vagina and the cervix will also be cleansed with antiseptic. A fine (2 mm) plastic tube is passed through the cervix into the uterus. The speculum is removed and a vaginal ultrasound scan is then performed as the saline (sterile salt water) is injected. The Saline is then drained and the contrast fluid (ExEm foam) is injected and watched real time with Ultrasound to check to see if the contrast material goes through the Tubes. 

Will I need an anaesthetic?

Whilst you may experience some mild discomfort, this is not usually a painful procedure and therefore no anaesthesia is required. However, to minimise crampy discomfort, 2 tablets of Bucopan is recommended 1 hour before the procedure. (These can be obtained from the chemist over the counter)

How will I feel after the procedure?

You may have some period-like cramps. Most women are comfortable enough to drive home and continue with usual daily activities, but if you are concerned about pain it may be worthwhile having someone available to drive you home. Local heat (hot water bottle or wheat bag) applied to the lower abdomen may be helpful to manage pain.

Some dark discharge from the vagina may be expected due to the Betadine antiseptic solution, so you may like to bring a panty-liner with you to the appointment.
If you develop symptoms of infection in the days after the procedure (eg. fever, loss or appetite, pelvic pain, unusual vaginal discharge) see your doctor as early as possible.


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