Post-Tubal Ligation – Hysterosalpingography
HSG
Post-tubal ligation indicates surgically interrupted fallopian tubes. On hysterosalpingography (HSG), contrast opacifies the proximal segments of the tube but abruptly terminates at the ligation site with no peritoneal spill.
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Findings: Proximal tubal segments may appear normal. Distal tubal segments are non-opacified due to surgical interruption. No free intraperitoneal contrast is observed.
Conclusion: HSG findings are consistent with post-tubal ligation status.
Patient Symptoms
Patients typically present for tubal occlusion confirmation after sterilization. Symptoms are generally absent.
Procedure (Hysterosalpingography)
HSG is performed during the early proliferative phase. Gentle contrast injection is essential to avoid discomfort or tubal injury.
Contrast Medium & Administration
Water-soluble iodinated contrast such as Iohexol or Iopamidol (300–350 mg iodine/mL) is used. 5–8 mL of contrast is injected slowly in the lithotomy position under fluoroscopic control.
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
Avoid high injection pressure to prevent pain or potential tubal injury. Active infection is a contraindication.
Related Conditions
Differentiation from partial tubal obstruction, congenital tubal anomalies, or post-inflammatory strictures may be needed. Correlation with surgical history is essential.
Declaration
This case is presented for academic and educational purposes only. Patient confidentiality has been preserved.
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