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Hysterosalpingography (HSG) is a procedure that uses a special form of X-ray to look at the fallopian tubes and uterus. It is a noninvasive medical test that is often used to find out why you are having difficulty conceiving. The doctor will check if the fallopian tubes are fully or partially blocked and if the inside of the uterus is normal.
Doctors also recommend HSG to examine repeated miscarriages that may be caused by congenital or acquired uterine problems, such as adhesions, endometrial (uterine) polyps, uterine fibroids, congenital problems (uterine anomalies), tumors. In addition, HSG can check the effects of tubal surgery, including:
Blockage of the fallopian tubes caused by scarring or infection
Reopening of the fallopian tubes after sterilization or a blockage caused by a disease
Closing of the fallopian tubes after sterilization procedures.
During HSG, you will have to lie on your back with your knees bent on a table under an X-ray imager called a fluoroscope. Then, a device called a speculum will be inserted into your vagina. This device holds the walls of the vagina apart, keeping it open and allowing your doctor to view the cervix. The cervix is then cleaned. In most cases, no sedation is used during the procedure, but your doctor may inject local anesthesia to the end of the cervix to numb the area. You may feel a slight pinch as this is done.
Next, a contrast medium will be placed in the uterus and fallopian tubes. A contrast medium is a fluid containing a dye that can show up the structures of your body on an X-ray screen. The dye can outline the inner size and shape of your uterus and fallopian tubes. Your doctor can also see how the dye moves through your body structures.
To place the contrast, the cervix is grasped with a special device to hold it steady. Then, an instrument called a cannula is inserted into the cervix. Through the cannula, your doctor gently fills your uterus with the contrast. After that, your doctor will remove the speculum, and as the contrast medium fills your uterus and tubes, images are made with the fluoroscope X-ray. You may be asked to move around so that your doctor can get side views. It is normal to feel cramping during this part.
Finally, once the images are taken, your doctor will remove the cannula.
HSG is an outpatient procedure, so you should be able to leave the hospital on the same day. In most cases, you can get the test results on the same day and discuss the results with your doctor right away, so you do not have to stay in Bulgaria any longer than you wish to. However, if the results are not immediately ready, plan to stay in the country for several days. Your doctor should give you the details.
You can resume your normal activities, including work, immediately after HSG. However, you should refrain from sexual intercourse for 2 to 3 days.
It is also important to note that you might have some vaginal spotting, cramps, stomach discomfort, and dizziness for a few days following the procedure. You can use pads for the vaginal discharge, but make sure to avoid using a tampon. Your doctor may give you antibiotics to prevent an infection and pain medicine to help you with any cramps and discomfort. If your doctor does not prescribe you pain medicine, you can take over-the-counter pain relievers.
HSG is a very safe procedure with high success rates. However, there are some complications that the procedure carries and they only occur with 1% of patients. These complications include infection, radiation exposure, fainting, allergic reaction to the contrast material, and spotting. Injury to your uterus or pelvic injury is possible as well.
The procedure is generally considered as effective and accurate most of the time. However, a small study revealed a 35% incident of false negatives. This means that the results showed a normal uterine shape, but other tests showed abnormalities. Also, 15% of women who undergo this procedure have a false-positive, meaning the results showed abnormalities when it is actually normal.
The following procedures can give your doctor similar information as HSG:
Hysteroscopy can provide a detailed view of the inside of your uterus, but it cannot give information about your fallopian tubes.
Laparoscopy can show if the fallopian tubes are open.
Sonohysterography can show the insides of your uterus. However, as with hysteroscopy, it cannot show whether your fallopian tubes are blocked.
Before HSG, you may have trouble conceiving or had two or more miscarriages, or you just underwent some tubal sterilization procedures. After the procedure, your doctor should be able to find any abnormalities that are causing the problem. The results will be able to help you and your doctor creates a treatment plan. If you have HSG because you have some tubal sterilization procedures before, the results will be able to tell if your fallopian tubes have been completely blocked.
Whilst the information presented here has been accurately sourced and verified by a medical professional for its accuracy, it is still advised to consult with your doctor before pursuing a medical treatment at one of the listed medical providers
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Bulgaria has plenty to offer and tourists are going to be very impressed with the country’s mountainous landscapes, beautiful Black Sea beaches, fascinating history, friendly locals, lively nightlife, and affordability. Although the country’s holiday tourism is very much on the radar, it is also actually quite popular with medical tourists, due to its modern medical centers, highly trained medical professionals, state-of-the-art equipment, affordable healthcare, and mineral baths, thousands of medical tourists visit this country each year. Most of the medical tourists come for dental treatment, orthopedic surgery, elective surgery, neurosurgery, as well as health screening.
Bulgaria’s laid-back capital city, Sofia, is truly a must-visit. It is full of museums, Ottoman mosques, communist architecture, chic galleries, Eastern Orthodox churches, amazing restaurants, and upbeat clubs. One of the most popular landmarks in the country is the Aleksander Nevski Cathedral, which is an awe-inspiring church built between 1882 and 1912 to honor 200,000 Russian soldiers who died fighting for the independence of Bulgaria during the Russo-Turkish war. If you want to relax on beautiful beaches visit Varna, which is a major tourist destination during the summer. The second-largest, city in Bulgaria is Plovdiv and it is one of the oldest continuously inhabited cities in Europe. Tourists are attracted by the Roman Amphitheatre, Archeological Museum, and Tsar Simeon Central Garden.
Most international tourists will arrive at Sofia Airport, which serves flights to most numerous major cities in Europe and the Middle East. There are several budget airlines that operate flights from this airport, including Ryanair and Wizz Air. Domestic flights are available, but they tend to be expensive. Therefore, to travel from one city to another, trains and buses are the best option. Buses and trains are punctual and affordable. However, if you are in a hurry, you should avoid trains as they can be a little slow. To travel around big cities, taxis are widely available and are really cheap. Just make sure you choose a licensed taxi to avoid being overcharged.
While Bulgaria is not yet a part of the Schengen Area, it has a visa policy that is based on the Schengen system. Therefore, holders of Schengen Visa are allowed to enter the country. Additionally, citizens of 62 countries, including the US, Australia, and the UAE, can stay in the country for up to 90 days without a visa.
From June to August, Bulgaria experiences summer. The weather can get a bit hot and humid, with an average temperature of 19°C to 21°C. July is the wettest month in the country. Winter, from December to February, is usually freezing. Autumn and Spring bring pleasant weather.