Yeah. Sure. Right.

Why is it that doctors don't want to hear about it if they hurt you. I'm still spotting today from that HSG the other day so I called and left a message at the nurse's station. I mentioned that it was more painful than last time. The nurse called back and said it was all normal and to be expected and that the bleeding might continue for a week, it's all individual she told me. And that the doctor said that it was totally normal and nothing out of the ordinary. I don't know, if I was going around hurting people with my technique I think I would want some feedback.

Nope, it's all just to be expected. I didn't expect any of it. Nothing except the infertility part.

Dang that hurts like a b*tch! (HSG Report)

I'm just back home from my HSG and what is there to report... I found it really painful again but thankfully I'm not having deep seated cramps right now (they made my knees weak last time three years ago). I had some bleeding/spotting right away afterwards which hopefully will stop before the end of the day.

The test showed that both tubes were open. Imagine the likelihood of that with all the mucking about in my woomba that's gone on in the past couple of years. The uterine shape looked pretty normal otherwise, no funny distortions from adhesions or fibroids this time.

I think they would have let my partner in to watch but since recents reports have said that it is best to limit your lifetime exposure to radiation, including x-rays, it's all for the best. And, as I said to my RE, I have found the HSG to be way more physically painful than a d&c since they sedate you for the d&c. It's over quick but DANG! OUCH! OW! OH! EEEEE! and THAT HURTS! I don't know who the people are who say it is no big deal, I hate it.

Also, a word to the wise, even if you can drive afterwards and go back to work doesn't mean that you should a) go by yourself or b) plan on going back to work. If your scan shows something is wrong, or if you have a strange reaction to the dye (such as weak knees or low blood pressure) then you will most certainly want someone there to take care of you. I'm staying at home the rest of the day and soon I will be taking a nap.

Hysterosalpingogram (HSG)

An HSG is a hysterosalpingogram, an x-ray of the interior space of the uterus and fallopian tubes using a contrast dye. It can be used to look for uterine abnormalities and adhesions, determine how much infringement fibroids are making into the interior of the uterus (to some degree), and identify if your tubes are open (referred to by docs as "patent"). Some docs do it standard a few months after a myomectomy, mine did not. The dye does have what my RE referred to as a "voodoo effect", where there is some slight increase in pregnancies after the procedure, speculated to be caused by the dye perhaps causing the little hairs (cilia) in the tubes to function better.

It can be done by your doctor in a radiology facility or by a radiologist -- mine was done by my RE and she was a lot more comfortable with the procedure than the radiologist I could tell.

They insert a catheter to insert the contrast dye through your cervix; a good cough evidently will open up the cervix so it is less painful. The dye feels like pressure going in, and it can cause a drop in blood pressure. It's generally uncomfortable and causes some cramping. My RE tried to manipulate my uterus for the xray shots using the special speculum and I found that to be very uncomfortable with my 6-7cm (at the time) fibroid.

Here is an link detailing Guidelines for the Performance of HSG - it advises taking 1000 mg of NSAIDs prior to the procedure.

Rarely it can cause infection, and some people are allergic to the contrast medium. Some docs give antibiotics preventatively ahead of time, they also might have you take a heavy dose of Tylenol an hour beforehand.

Here are some links to sites showing images from HSGs:

HSG Link 1

HSG Link 2
HSG Link 3

I should go pick up my x-ray film from the University of Washington Radiology Department, where I brought it when I consulted about UAE a couple years ago. I'd like to scan it and and post it here so you can see what my distorted uterus looked like.

Pelvic Adhesions

Adhesions are really common after pelvic surgery but they don't necessarily have to cause you problems or impact your fertility. Some doctors will perform an HSG (hysterosalpingogram) a few months after a myo for women wanting to try to conceive but mine thought we should just see what happened for a few cycle on our own. We were able to conceive and have implantation in my uterus so no problems there for me.

Adhesions & Pelvic Pain
What Women Need To Know About Prevention and Treatment

Pelvic Adhesions

Pelvic Adhesions - Their Role in Infertility and How to Prevent Them
PDF brochure from RESOLVE

Reduction of Adhesions

Asherman's Syndrome

Pelvic Abnormalities: Pelvic Adhesions (photos)

International Adhesions Society
(they are also conducting a survey of patients regarding informed
consent forms with regards to mention of adhesions)

Adhesion Related Disorders

Chronic Pelvic Pain
(includes some info about how to minimize adhesion formation)

Pelvic Adhesions
(fairly clinical and scientific information about adhesion formation and prevention in a Powerpoint presentation)

Pelvic Pain Needing Treatment

Wound Healing and Scarring - Sutures

Prospective clinical trial of SprayGel as a barrier to adhesion formation: an interim analysis.
(there are other media that can be used to prevent adhesion formation as well, if you are interested continue searching on these terms:
"pelvic adhesions barrier agents")