Can Hysterosalpingography be Performed if There is Cervical Canal Adhesion?

Cervical ostium adhesion can be evaluated for uterine cavity morphology and patency through hysterosalpingography (HSG), but it requires a doctor's judgment based on specific circumstances to determine its suitability. Cervical ostium adhesion refers to the partial or complete closure of the cervical canal by fibrous tissue or scars, which may affect menstruation, uterine health, and fertility. Although HSG is a commonly used method for diagnosing uterine cavity diseases, its administration requires caution, especially when the lesion is clear or inflammation is present, and other diagnostic or therapeutic means should be considered.

Cervical ostium adhesion is mostly caused by trauma, infection, surgical procedures, or hormonal imbalances and can manifest as symptoms such as hypomenorrhea, amenorrhea, dysmenorrhea, infertility, or cyclic lower abdominal pain. HSG (such as hysterosalpingo-contrast sonography) can help understand the extent of intrauterine adhesions and the patency of the fallopian tubes, but pelvic infections, acute inflammation, and other contraindications need to be ruled out before the procedure. Doctors usually combine medical history, physical examination, and ultrasonography to decide whether HSG is needed.

If cervical ostium adhesion is suspected as the cause of a disease, doctors may recommend HSG. However, caution is needed in the following situations: When inflammation is uncontrolled: HSG should be avoided to prevent infection spread. In cases of severe adhesion: Hysteroscopy can be chosen for more precise diagnosis and treatment. When pregnancy has not been ruled out: HSG should be avoided to prevent possible harm to the embryo. To prevent discomfort or risks during the examination, patients need to strictly follow medical advice and may require antibiotics before the examination to prevent infection.

If HSG cannot be performed for various reasons, the following methods can also aid in diagnosis or treatment: Ultrasonography: Uses ultrasound to make a preliminary judgment on uterine cavity morphology and adhesion. Hysteroscopic surgery: Not only allows for intuitive diagnosis but also directly performs adhesion separation surgery, which is currently the primary means of adhesion treatment. Pharmaceutical intervention: Hormonal medications are used to restore endometrial function and promote self-improvement of mild adhesions. For post-diagnosis treatment, mild adhesions can be treated with medications or physical therapy (such as cervical dilation); moderate to severe adhesions require consideration of hysteroscopic surgical intervention. HSG can aid in the diagnosis of cervical ostium adhesion, but it is not suitable for all patients, and the decision to proceed should be based on individual circumstances. Following the advice of professional doctors and choosing appropriate diagnostic and therapeutic means are key to maintaining health.