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The Procedure

  • On arrival you will be asked to empty your bladder and shown into the ultrasound room.
  • A transvaginal ultrasound will be performed – this is a routine examination and should not hurt.
  • A speculum is then placed into the vagina (similar to a smear examination).
  • A catheter (tube) is inserted into the uterus.
  • The ultrasound transducer (probe) is reinserted and fluid will be injected down the catheter.
  • If the tubes are normal the fluid will be seen to flow through them on the ultrasound image.
  • We will discuss the results of the procedure if you wish.


Background Information

HyCoSy is an investigation of the fallopian tubes.

The fallopian tubes carry the egg from the ovaries to the uterus. If the tubes are damaged or blocked it may be difficult to become pregnant.

It is not possible to see these tubes with normal x-rays or ultrasound.

HyCoSy is a specialised ultrasound examination to look at the tubes.

Please bring a sanitary towel with you on the day of the examination as the dye is sticky

You should, ideally, be accompanied home (but not on public transport) and are advised to bring a relative or a friend with you to your appointment, who can accompany you into the examination room if you wish.

It is normal to have some vaginal bleeding and / or discharge. There is a very small risk of infection. If you suspect you may have an infection (e.g. temperature, pain, bleeding and discharge) you should contact your GP or attend St Peter’s Hospital A/E department.

SIS (Saline Infusion Sonography) is also used to investigate uterine cavity abnormalities in women who experience infertility or multiple miscarriages.


What are the limitations of HyCoSy and SIS?

HyCoSy should typically not be performed in women with active pelvic inflammatory disease.

HyCoSy may have a few limitations in certain clinical situations. In women with stenosis of the cervix, it may be somewhat difficult to insert the catheter into the cervical canal so that saline may be injected. Inadequate distension (expansion) of the uterine cavity from the saline injection may also prevent good-quality ultrasound images from being obtained. This can occur especially with uterine adhesions (scarring) or large benign tumors called fibroids, which may partially obliterate the uterine cavity.

Also, HyCoSy is limited in the assessment of the patency, or openness, of the fallopian tubes because of their size and structure. In such cases where an abnormality of the fallopian tubes is suspected, a procedure such as hysterosalpingography (HSG) might be recommended for further evaluation.


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