Prominent Cervical Glands (HSG)

Prominent Cervical Glands – Hysterosalpingography

Prominent cervical glands represent dilatation of endocervical glands, most commonly due to chronic cervicitis or mucus retention. These glands may be seen incidentally on hysterosalpingography (HSG) as benign findings. On HSG, they appear as multiple small, smooth, contrast-filled outpouchings arising from the cervical canal, typically symmetric and without associated canal distortion (Fig. 1).

Fig-1

Fig. 1—Hysterosalpingogram showing prominent cervical glands. Multiple small, smooth, contrast-filled sacculations are seen along the cervical canal (arrows), giving a beaded appearance.

Findings: The cervical canal is patent and of normal caliber. Numerous tiny, rounded contrast collections project from the canal walls. The uterine cavity and fallopian tubes are normal with free peritoneal spill.

Conclusion: Hysterosalpingographic appearance is consistent with prominent cervical glands, a benign finding.

Patient Symptoms

Most patients are asymptomatic. Some may have a history of chronic cervicitis, vaginal discharge, or mild postcoital spotting.

Procedure (Hysterosalpingography)

The examination is performed during the early proliferative phase of the menstrual cycle. A cervical cannula or balloon catheter is placed, and water-soluble contrast is injected gently under fluoroscopic guidance to outline the cervical canal, uterine cavity, and fallopian tubes.

Contrast Medium & Administration

A water-soluble iodinated contrast agent such as Iohexol or Iopamidol (300–350 mg iodine/mL) is used. The patient is positioned in the lithotomy position. Approximately 5–8 mL of contrast is sufficient.

Instruments Used

• Sterile vaginal speculum (Cusco’s or Sims’)
• Leech–Wilkinson cannula
• Rubin cannula
• Balloon HSG catheter
• 10–20 mL sterile Luer-lock syringe
• Sterile connecting tubing
• Antiseptic solution
• Fluoroscopy unit

Safety Considerations

Gentle injection is recommended to avoid excessive filling of glands, which may mimic cervical diverticula. Pregnancy and active pelvic infection must be excluded.

Related Conditions

Differential diagnoses include cervical diverticulum, nabothian cysts (non-communicating), chronic cervicitis, and cervical fistula. Clinical correlation is usually sufficient.

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Declaration

This case is presented for academic and educational purposes only. Patient confidentiality has been preserved and no identifiable information is disclosed.