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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 Santo Domingo 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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Santo Domingo, the capital of the Dominican Republic and is the most modern and largest metropolis in the Caribbean. The city is the cultural, political, financial, industrial, and commercial center of the Dominican Republic. Founded by Bartholomew Columbus in 1496, Santo Domingo is the oldest styled European City in the Americas. The city has everything that will make any visit worthwhile, from large shopping malls, historical architecture, seaside resorts, to a vibrant nightlife.
Over the last several years, medical tourism in Santo Domingo has been growing steadily. The city contributed to the Dominican Republic’s medical tourism average income of US$265.0 million in 2018. The most popular procedures in Santo Domingo are cosmetic and plastic surgery, dental surgery, cardiology, and heart surgery. Santo Domingo has everything a medical tourist could ask for, including:
Located in the heart of the Caribbean, Santo Domingo has a rich historical and cultural heritage. The Colonial City, a UNESCO World Heritage Site, will amaze tourists with its beautiful architecture and rich history. The neighborhood consists of colonial buildings turned into shops, hotels, museums, and cafés. History fans can enjoy the oldest standing cathedral in the Western hemisphere: Catedral Primada de América.
Mercado Modelo is shopping heaven on Avenida Mella on the outskirts of Colonial City. Tourists will find an indoor maze of small shops offering local crafts, treats, and specialties.
Tourists who want to indulge in nature can go to Jardín Botánico Nacional de Santo Domingo as the gardens are filled with native plants and offer an excellent insight into the natural flora of Santo Domingo, the largest botanical gardens in the Caribbean. The botanical gardens are also home to hundreds of different kinds of orchids.
Santo Domingo has many wonderful beaches since the city’s waterside stretches along the Caribbean Sea. Tourists can go to Playa Najayo or Playa Juan Dolio for picturesque views or enjoy the sparkling blue water. The sunsets are particularly breathtaking.
The city enjoys a tropical climate that sees warm and humid weather all year long. The wet season (rainy season) starts from May to November, the average temperature on the wet season is around 22 - 31°C with the humidity slightly higher.
December to April is the best time to visit Santo Domingo since it is the dry season. The average temperature ranges between 19°C to 29°C. Showers may occur but they usually do not last long. Tourists should avoid traveling to Santo Domingo during Hurricane Season which runs from August to October.
There are two airports in Santo Domingo. The main airport is Las Américas International Airport (also known as Santo Domingo Airport), located Punta Caucedo and Boca Chica, 32km east of the city. This airport has international connections from North America, South America, and Central America to Europe. The airport serves many major airlines such as Delta, Emirates, and American Airlines. Las Américas International Airport also serves budget airlines such as JetBlue. La Isabela International Airport primarily serves domestic flights and some international flights to other Caribbean Islands. The airport is the major hub for Dominican airlines that operates small aircraft.
To get into the city from the airports, tourists can choose taxi, airport shuttle, public bus, shared van, or car rental. Traveling by taxi can get a bit more expensive although it is a good transportation option. The cost to Colonial City from Las Américas International Airport is around US$40. The cheaper option is to ride the public bus (Guagua), the buses depart to Parque Enriquillo in the city center and to Boca Chica.
Getting around in Santo Domingo is fairly easy. To get the most of Colonial City, walking is the best way since they offer plenty of pedestrian attractions, but walking along streets outside Colonial City can be quite challenging.
Taxis in Santo Domingo don’t use meters, tourists have to agree on the fare in advance. The standard fare is around RD$250. It is best not to take any unmarked taxi because it could be dangerous. Tourists usually need to call a dispatcher to have a taxi sent to their location, most businesses and hotels will gladly call a taxi for tourists and this is the safest option.
Tourists can take Públicos, minivans that follow a predetermined route but stops wherever someone flags them down. The fare usual fare is RD$25. Tourists can also take the Santo Domingo Metro, rides cost around RD$15, a contactless card can be purchased to use the metro.
Buses are also available from 6.30 am to 9.30 pm and cost around RD$25, the bus stops are marked with a sign and a word parade which means stop, the routes tend to follow major streets.
Dominic Republic exempts nationals from 107 countries including the US, Canada, most South American countries, the European Union, and several other countries from Asia and Africa from obtaining a tourist visa. A passport valid for at least six months is required to enter the country.
Visitors need to apply for a tourist card that can be obtained at the Dominican Consulates or directly upon arrival at the airports in the Dominican Republic. The tourist card costs US$10 and is valid for 30 days. Tourists who want to extend their visit will have to go to the offices of Direccion General de Migracion and pay for an extension.