2. Dr. Mustafa Zuhair Mahmoud
B.Sc; SUST {Khartoum, Sudan}
M.Sc; AAU {Khartoum, Sudan} & JUREI {Philadelphia, USA}
Ph.D, Ludes {Lugano, Swiss}
Ph.D, SUST {Khartoum, Sudan}

3. Female
Reproductive-System
Radiography

4. Quick Anatomical
Review

5. The female reproductive organs are divided into:
An internal group lies in the true pelvis.
An external group lies below& in front of the
pubic arch.
The internal organs are:
Two ovaries.
Two uterine (fallopian) tubes.
Uterus.
Vagina.
The external organs are:
Collectively called the Vulva.
{Our lecture isn’t addressing the anatomy of the external
genitalia because those structures don’t require radiographic
demonstration.}

7. The Ovaries:
The ovaries are female “Sex
Glands”& they lie, one on each side
of the uterus.
Each is attached to the upper layer
of a peritoneal fold, called the broad
ligament of the uterus.
Each ovary is about 3cm in length,
1.5cm in width& 1cm thick.

8. The structure of the ovaries:
Each ovary is composed of:
an outer zone called the cortex.
an inner zone called the medulla.

10. The Uterine (Fallopian) Tubes:
The uterine tubes lie in the upper margins of the broad
ligament of the uterus.
They are each about 10cm in length& they serve to
transmit the ovum from the ovary to the uterus.
Fallopian tubes divided, for descriptive purpose, into four
parts:
The infundibulum.
The ampulla.
The isthmus.
The uterine portion.

12. Structure of the Uterine Tubes:
The uterine tubes are composed of three coats:
Outer serous coat.
Middle muscular coat.
Inner mucous coat.

13. The Uterus:
The uterus is a hallow, pear shaped muscular organ,
which is approximately 7.5cm in length, 5cm in width&
2.5cm in thick.
It’s divided for descriptive purposes, into two parts:
Body –corpus- of the uterus.
Cervix of the uterus.
The structure of the uterus:
Uterus is composed of three layers:
Outer serous coat.
Middle muscular coat.
Inner mucous coat.

15. The ligament of the uterus:
The uterus is supported by several ligaments:
The broad ligament.
The round ligament.
The anterior& posterior ligament.

17. The vagina:
The vagina is a fibromuscular canal, about 7.5cm in
length, which extends from the vulva to the uterus.
The structure of the vagina:
The vagina is composed of three coats:
Outer coat of loose areolar tissue.
Middle coat of smooth muscle.
Inner coat of mucous membrane.

19. Hysterosalpingography= HSG
Definition:
Hysterosalpingography is a procedure
where X-rays are taken of a woman's
reproductive tract after a dye is injected.
Hystero means uterus and salpingo means
tubes, so hysterosalpingography literally
means to take pictures of the uterus and
fallopian tubes. This procedure may also be
called hysterography (or HSG).

20. Indications for imaging:
- Infertility.
- To detect a blocked fallopian tube.
- To detect uterine abnormalities, such as uterine anomalies, endometrial polyps,
fibroids, intrauterine adhesions, genital tuberculosis.
- To evaluate the results of tubal surgeries, such as a tubal ligation.

21. Patients Preparation:
- An HSG is usually scheduled within 2-5 days after the period ends (day 7-10
of the menstrual cycle) and before ovulation (day 14 of the cycle) to avoid
exposing the uterus to radiation and X-ray dye, if the woman is pregnant. Tell
your doctor if you might be pregnant.
- If you have had a pelvic inflammatory disease or sexually transmitted
disease (gonorrhea, chlamydia, etc.), you are at a higher risk of developing
complications after the HSG. Tell your doctor if you suspect pelvic infection,
as you may need to take antibiotics before the test.
- Tell your doctor before the test if you:
- are allergic to X-ray dye (iodine), any medications
or foods.
- are asthmatic.
- are taking any medications.
- have any bleeding disorders.

22. CONTRAST MEDIA FOR *HSG
• A.
• B.
Water soluble media
Oily contrast media
*HSG, Hysterosalpingography

23. CONTAINS:
Disposable Speculum
Disposable Cervical Dilator
Three Swab Sticks
One Wide Swab
Sterile Wrap
Two 3" x 3" Pads
Inner Tray for Povidone - Iodine
Solution
Povidone-Iodine Solution (2 packets)
36" Extension Tube
20cc Syringe with 18-Gauge Needle
Lubricating Jelly Packet

24. Patient Position:
Lithotomy Position:
“A recumbent (supine) position knees and hip flexed
and thighs abducted and rotated externally, supported
by ankle supports.”

28. Hysterosalpingogram - contrast (iodine) has been injected into
the uterus through a catheter and the uterine cavity and
fallopian tubes are opacified - they look white on the image. (A:
right tube, B: uterine cavity, C: left tube, D: catheter with
balloon tip)

29. THANKS