Τι είναι η υστεροσαλπιγγογραφία (HSG);
Υστεροσαλπιγγογραφία (HSG) είναι μια μέθοδος απεικόνισης του εσωτερικού της μήτρας και των σαλπίγγων. Συχνά χρησιμοποιείται για να δούμε αν οι σάλπιγγες είναι αποκλεισμένες πλήρως ή εν μέρει. Επίσης, μπορεί να δείξει αν το εσωτερικό της μήτρας είναι ένα κανονικού μεγέθους και σχήματος. Όλα αυτά τα προβλήματα μπορούν να οδηγήσουν σε στειρότητα και σε άλλα μαιευτικά προβλήματα.
HSG χρησιμοποιείται επίσης για απόφραξη-απολίνωση των σαλπίγγων, όπως και για να βεβαιωθείτε ότι οι σάλπιγγες έχουν αποκλειστεί εντελώς.
HSG δεν γίνεται αν μια γυναίκα έχει οποιαδήποτε από τις ακόλουθες προϋποθέσεις:
- Εγκυμοσύνη
- Πυελική μόλυνση
- Βαριά αιμορραγία της μήτρας κατά τη στιγμή της διαδικασίας
Τι πρέπει να κάνω για να προετοιμαστώ πριν μια HSG;
Ο γιατρός σας μπορεί να σας συστήσει να πάρετε ένα κοινό παυσίπονο μία ώρα πριν από τη διαδικασία. Συζητήστε την απόφαση αυτή με τον ιατρό σας. Σε ορισμένες περιπτώσεις, μπορεί επίσης να σας συνταγογραφήσει ένα αντιβιοτικό για να πάρετε πριν HSG. Οι περισσότερες μπορούν να οδηγήσουν στο σπίτι έπειτα από μια HSG. Ωστόσο, ίσως να μην αισθάνεστε καλά μετά την επέμβαση.
Πώς γίνεται η υστεροσαλπιγγογραφία;
HSG γίνεται σε διαγνωστικό – απεικονιστικό κέντρο. Είναι καλύτερο να γίνει κατά την πρώτη φάση (1-14 ημέρες) του έμμηνου κύκλου. Αυτό το χρονοδιάγραμμα μειώνει την πιθανότητα ότι μπορεί να είστε έγκυος.
Κατά τη διάρκεια της HSG, ένα μέσο αντίθεσης-contrast τοποθετείται στη μήτρα και τις σάλπιγγες. Αυτό είναι ένα υγρό που περιέχει μία βαφή. Η βαφή εμφανίζεται, σε αντίθεση με τις δομές του σώματος σε μια οθόνη ακτίνων Χ. Η βαφή περιγράφει το εσωτερικό μέγεθος και το σχήμα της μήτρας και των σαλπίγγων. Είναι επίσης πιθανό να δούμε πώς η χρωστική ουσία κινείται μέσα από τις δομές του σώματος.
Η διαδικασία γίνεται ως εξής:
Θα σας ζητηθεί να ξαπλώσετε ανάσκελα με τα πόδια σας να τοποθετούνται όπως σε μια γυναικολογική εξέταση. Μια συσκευή που ονομάζεται σαλπιγγογράφος εισάγεται στον κόλπο. Κολποδιαστολέας κρατάει τα τοιχώματα του κόλπου απομακρυσμένα έτσι ώστε ο τράχηλος να είναι ορατός. Ο τράχηλος καθαρίζεται.
Σε τμήμα του τραχήλου γίνεται έγχυση διαλύματος με τοπική αναισθησία (ανακούφιση του πόνου). Μπορεί να αισθανθείτε ένα μικρό τσίμπημα ή ένα ήπιο τράβηγμα κατά τη διαδικασία.
Ακολουθεί έγχυση διαλύματος σκιαγραφικού μέσου.
Στη συνέχεια τοποθετείστε κάτω από ένα μηχάνημα ακτίνων Χ.
Το υγρό αργά τοποθετείται διαμέσου του σωληνίσκου ή του σωλήνα μέσα στην κοιλότητα της μήτρας και των σαλπίγγων. Το υγρό μπορεί να προκαλέσει κράμπες. Εάν οι κοιλότητες είναι μπλοκαρισμένες, το υγρό μπορεί να τις αποφράξει.
Καθώς το μέσο αντίθεσης – σκιαγραφικό γεμίζει τη μήτρα και τους σωλήνες, λαμβάνονται εικόνες-ακτινογραφίες. Μπορεί να σας ζητηθεί να αλλάξετε τη θέση. Αν δεν υπάρχει απόφραξη, το υγρό θα χυθεί έξω αργά από τις σάλπιγγες στην περιτοναϊκή κοιλότητα. Αφού χυθεί έξω, το υγρό απορροφάται από το σώμα.
Μετά από τη λήψη των ακτινογραφιών ο σαλπιγγογράφος αφαιρείται.
Τι πρέπει να περιμένω μετά την επέμβαση;
Μετά την HSG, μπορεί να παρατηρήσετε ροή υγρού από τον κόλπο. Το υγρό μπορεί να είναι χρωματισμένο με αίμα. Μια σερβιέτα μπορεί να χρησιμοποιηθεί για την κολπική έκκριση. Μην χρησιμοποιείτε ταμπόν. Μπορείτε επίσης να έχετε τα ακόλουθα συμπτώματα:
- Ελαφρά κολπική αιμορραγία
- Κράμπες
- Ζάλη, λιποθυμία, ή αδιαθεσία στο στομάχι σας
Ποιοι είναι οι κίνδυνοι της υστεροσαλπιγγογραφίας;
Σοβαρά προβλήματα μετά από ένα HSG είναι σπάνια. Περιλαμβάνουν μια αλλεργική αντίδραση στο σκιαγραφικό, τραυματισμό της μήτρας, ή πυελική μόλυνση. Καλέστε το γιατρό σας εάν έχετε κάποιο από αυτά τα συμπτώματα:
- Δύσοσμο κολπικό έκκριμα
- Εμετός
- Λιποθυμία
- Σοβαρός κοιλιακός πόνος ή κράμπες
- Βαριά κολπική αιμορραγία
- Πυρετός ή ρίγη
Υπάρχουν εναλλακτικές λύσεις για HSG ;
Λαπαροσκόπηση – χειρουργική επέμβαση υπό γενική αναισθησία.
Υστεροσκόπηση μπορεί να δώσει μια λεπτομερή εικόνα του εσωτερικού της μήτρας. Ωστόσο, δεν μπορεί να δείξει αν οι σάλπιγγες εμποδίζονται.
Υπερηχογραφική απεικόνιση μετά από έγχυση ύδατος στη κοιλότητα της μήτρας. Αυτή η τεχνική χρησιμοποιεί υπερήχους για να δείξει το εσωτερικό της μήτρας. Όπως και η υστεροσκόπηση, δεν παρέχει πληροφορίες σχετικά με τις σάλπιγγες.
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