A HyCoSy is a procedure to check if the Fallopian tubes are open.
What is a HyCoSy?
HyCoSy checks the Fallopian tubes are open by injecting a small amount of fluid (Exem foam contrast solution) into the uterus through a thin catheter and observing it with ultrasound. The test is mainly performed for the investigation of sub-fertility.
It is comparable to the radiology procedure known as HSG, but does not use any radiation, and allows avoidance of iodine-based solutions, for those people with an iodine allergy.
The procedure should not be performed if you are, or may be, pregnant at the time. It should also be delayed until following treatment of suspected or confirmed pelvic infection.
How is the Procedure Performed?
On the day, a transabdominal or transvaginal ultrasound scan may be required immediately before the procedure. You will be advised at the time if this is the case.
Before the procedure, you will need to undress from the waist down and empty your bladder completely. When lying on the bed, you will be covered with a sheet, and your legs placed in stirrups. The external genitals will be washed with an antiseptic solution.
A speculum will be passed into the vagina, and the cervix also washed with antiseptic. A thin plastic catheter (tube) is passed into the cervix. When it reaches the upper cervix or uterine cavity, a small balloon at its tip is inflated, to keep it in position. The speculum is then removed, and a transvaginal ultrasound is performed as the Exem foam is injected. You will be advised of what is happening as the procedure occurs.
Is it painful?
There is some discomfort associated with the procedure, similar to period pain. The intensity of the discomfort varies between women, but is not usually too painful.
It is strongly recommended to take 2 tablets of an anti-inflammatory medication (such as Ponstan, Nurofen or Naprogesic) an hour before your appointment. This is helpful, not only to minimise crampy discomfort, but also to relax the uterus, enabling the procedure to be performed with greater ease. If you are unable to take anti-inflammatories, due to allergies, asthma or other reasons, use of simple analgesics, such as Panadol is an alternative.
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Are there any risks?
The most common ill-effect is the discomfort . However, with use of an anti-inflammatory beforehand, most women will find the procedure not too unpleasant.
There is a small risk of introducing infection into the uterus and pelvis. If you become unwell in the days or weeks that follow the procedure, with symptoms of fevers, loss of appetite, lower abdominal or pelvic pain, or unusual discharge, please see your referring doctor or your local GP at your earliest convenience.
Occasionally, the catheter cannot be passed into the cervix far enough to remain in place. If this occurs the procedure cannot be completed, but a fee will still apply.
Rarely, handling of the cervix results in a reflex fall in blood pressure (called cervical shock ). This can lead to feeling faint and dizzy or passing out. If you become faint, or lose vision or hearing during the procedure, please alert the staff immediately.
It is possible that the contrast fluid (Exem foam) may not be seen to pass through the Fallopian tubes, even if they are open. This may be due to uterine cramping preventing flow into the open tubes, or to bowel gas obstructing the view of contrast flowing through the tubes. In this situation, the HyCoSy result will suggest tubal blockage. Your referring doctor will discuss with you whether or not you should consider having a laparoscopy (keyhole surgery) to confirm the diagnosis. If the contrast fluid can be seen moving freely through the tubes, laparoscopy and its associated risks can be avoided.
What preparation is required for the procedure?
The bladder will need to be empty during the procedure, so drinking extra fluids before your appointment is not required. Antibiotics are not required routinely before the procedure, but if you have other conditions which increase your risk of infection, or if you have had a recently treated infection, you should talk to your referring doctor about taking a dose of antibiotics a couple of hours beforehand.
How will I feel after the procedure is over?
You will probably have some persisting period-like cramps for a few hours. Using further simple analgesics, or local heat (hot water bottle or wheat bag) can help. Some women prefer to have someone with them to drive them home, but it is quite reasonable to drive yourself if you need to. Returning to work immediately after the procedure is possible if required, but you may prefer to have a restful afternoon instead.
You should expect some dark discharge from the vagina for a short period of time, due to the Betadine antiseptic. We suggest you wear dark undies and bring a panty-liner to wear afterwards. If you develop symptoms of possible infection (as described above), please see your referring doctor or local GP as early as possible.
How do I make a booking?
Complete the HyCoSy history sheet which follows, then fax it along with your referral to 9481 4080. Bring this consent form with you to sign on the day. Call QDOS Ultrasound Perth on the first day of your next period. Available appointments between your period and anticipated ovulation will be offered to you. Please abstain from intercourse from the first day of your period, until the procedure has been performed.