HSG dan BPH

HYSTEROSALPINGOGRAPHY (HSG)
• Female reproductive organs :
– Uterus
– Right and left ovaries
– Adnexa

• Disorders of these organs can be detected by :

– USG
– CT-scan
– MRI
– Conventional X-ray
Plain abdominal film (KUB = kidney - ureter – bladder = scout film) for
detecting :
A. Types of female pelvis
1. GYNECOID type
2. ANTHROPOID type
3. ANDROID type
4. PLATYPELLOID type
B. Mass or calcification in the pelvis
C. Existence of ascites
D. To detect the existence of IUD (Intrauterine
Device)
Plain abdominal film
 A=gaster
F=liver
B=decending colon
G=Cecum
C=hepatic flexura
H=Sacrum
D=left psoas border
I=left iliac bone
E=renal flexura
J=left head of femur

plain abdominal film

Pelvic film which shows the existence of IUD
(Cu-T) in the pelvis
IVP which shows the existence of dermoid cyst which
contain teeth inside the cyst
Aims : to detect the condition of uterine
cavity and both Fallopian tubes.

Contrast media :
1. Senyawa Iodium (Lipiodol ; Ultravist) 10 cc
Indication :
1. Infertility : primary or secundary
2. To detect the causes of repeated abortion
- congenital anomaly of the uterus
- tumors of the uterus
- incompetence of sphincter muscles of internal
uterine orifice
3. To monitor the result of tubal reconstruction surgery.
Contraindication :
1. gravid
2. menstruation
3. acute infection of the uterus and the tuba
4. severe heart and renal disease
5. recent curretage
6. hypersensitivity and alergic to the contrast
media
Complication of HSG :
1. lower abdominal pain
2. Intravatation of the contrast media into the veins
3. Exaserbation of infection caused by unsterility of
the equipment used
The HSG will show :
1. condition of cervical canal uteri .
2. condition of uterine cavity
3. condition of the tubes : chronic salpingitis
(paratubal filling) or hydrosalpynx /pyosalpynx.
4. the patency of the tubes spill (+) or spill (-)
 NORMAL HSG :

1. AP view 2. Lateral view

 ABNORMAL HSG
1. Congenital anomaly of the uterus :
- Uterus didelphys.
- Uterus bicornis bicollis
- Uterus bicornis unicollis
- Uterus unicornis unicollis
- Uterus arcuata
- Uterus unicornuata / bicornuata
Congenital Anomaly of the Uterus

Uterus normal Uterus arcuata

Uterus bicornuate Uterus bicornuate

unicollis bicollis
2. Uterine Myoma :
- there is filling defect in the uterine cavity

3. Abnormalities of Fallopian tube :

- salpingitis TBC ( micro- calcification outside
of the tube).
- hydrosalpynx - pyosalpynx
HIPERTROFI PROSTAT
Risk factors for developing BPH include:
• Obesity
• Lack of physical activity
• Erectile dysfunction
• Increasing age
• Family history of BPH
GEJALA KLINIK
 DIAGNOSIS
• prostate specific antigen (PSA) - a blood test to screen for prostate cancer
• urinary cytology - a urine test to screen for bladder cancer
• a measurement of post-void residual volume (PVR), the amount of urine left in
the bladder after urinating
• uroflowmetry, or urine flow study, a measure of how fast urine flows when a
man urinates
• cystoscopy - a direct look in the urethra and/or bladder using a small flexible
scope
• urodynamic pressure-flow study - tests the pressures inside the bladder
during urination
• ultrasound of the kidney or the prostate – to view the enlargement
 PEMERIKSAAN RADIOLOGI
• USG
• CYSTOGRAPHY
• CT-SCAN
• MRI