Kegiatan pemeriksaan histerosalpingografi (HSG) pada kasus infertilitas

Abstract

Background: Infertility is a common reproductive problem experienced by couples of childbearing age, with approximately 35% of cases caused by disorders or damage to the fallopian tubes. To assess fallopian tube patency and detect uterine abnormalities, a frequently used radiological method is hysterosalpingography (HSG), an examination using contrast media that allows for accurate evaluation of anatomical structures and identification of factors causing infertility. Purpose: To describe the hysterosalpingography (HSG) examination procedure, patient preparation and equipment, and radiographic results in infertility cases, regarding the application of radiological standards in clinical practice. Method: The study was conducted from March to May 2025 at the Radiology Department of Siloam Sriwijaya Hospital, Palembang, using a qualitative descriptive case study method. The sample consisted of one patient who met the criteria, with data obtained through direct observation, literature review, documentation, and interviews with radiographers. All data were then processed and analyzed descriptively to describe the examination stages, preparation, and HSG radiographic results in infertility cases. Results: The examination was performed using plain radiographs, anteroposterior (AP), right posterior oblique (RPO), and left posterior oblique (LPO) projections. The contrast medium used was Omnipaque (Iohexol), a water-soluble imaging medium, with an exposure factor of 70 kV and 12 mAs. The radiological examination revealed a normal uterus, a patent right fallopian tube with a positive spill sign, and a non-patent left fallopian tube with peritubal adhesions. Conclusion: Hysterosalpingography (HSG) examinations for infertility cases at Siloam Sriwijaya Hospital, Palembang, were performed consistently and in accordance with standard radiological procedures. The primary indication for the examination was infertility. There were slight technical differences between computed radiography (CR) and digital radiography (DR) in terms of exposure, patient preparation, equipment and material preparation, and projections. However, the image results remained optimal. Suggestion: HSG examinations are expected to continue to adhere to evidence-based standard operating procedures (SOPs) to ensure patient safety and diagnostic quality. The use of digital radiography (DR) technology can be further optimized to produce consistent and accurate images and minimize the risk of complications. Furthermore, it is important to improve patient education regarding examination preparation, strengthen documentation of results, and conduct regular evaluations of procedures to maintain alignment between theory and practice and support quality radiology services. Keywords: Fallopian tubes; Hysterosalpingography; Infertility examination; Radiographic procedures Pendahuluan: Infertilitas merupakan salah satu masalah reproduksi yang banyak dialami pasangan usia subur, dengan sekitar 35% kasus disebabkan oleh gangguan atau kerusakan pada tuba fallopi. Untuk menilai patensi tuba fallopi serta mendeteksi kelainan pada uterus, salah satu metode radiologi yang sering digunakan adalah histerosalpingografi (HSG), yaitu pemeriksaan dengan media kontras yang memungkinkan evaluasi struktur anatomi dan identifikasi faktor penyebab infertilitas secara akurat. Tujuan: Mendeskripsikan prosedur pemeriksaan histerosalpingografi (HSG), tahapan persiapan pasien dan alat, serta hasil radiografi pada kasus infertilitas mengenai penerapan standar radiologi dalam praktik klinis. Metode: Penelitian dilaksanakan pada Maret–Mei 2025 di Instalasi Radiologi RS Siloam Sriwijaya Palembang dengan metode studi kasus deskriptif kualitatif. Sampel berupa satu pasien yang memenuhi kriteria, dengan data diperoleh melalui observasi langsung, studi kepustakaan, dokumentasi, dan wawancara radiografer. Seluruh data kemudian diolah dan dianalisis secara deskriptif untuk menggambarkan tahapan pemeriksaan, persiapan, serta hasil radiografi HSG pada kasus infertilitas. Hasil: Kegiatan pemeriksaan dilakukan dengan proyeksi plain photo, anteroposterior (AP), serta right posterior oblique (RPO) dan left posterior oblique (LPO). Media kontras yang digunakan adalah Omnipaque (Iohexol) yang bersifat larut air, dengan faktor eksposi 70 kV dan 12 mAs. Pemeriksaan radiologi memperlihatkan gambaran uterus normal, tuba fallopi kanan patent dengan spill sign positif, serta tuba fallopi kiri non-patent dengan adanya peritubal adhesion. Simpulan: Kegiatan pemeriksaan histerosalpingografi (HSG) pada kasus infertilitas di Rumah Sakit Siloam Sriwijaya Palembang dilaksanakan secara konsisten dan sesuai standar prosedur radiologi. Indikasi utama pemeriksaan adalah infertilitas, dengan faktor eksposi, persiapan pasien, persiapan alat dan bahan, serta faktor proyeksi yang digunakan, terdapat sedikit perbedaan teknis antara penggunaan computed radiography (CR) dan digital radiography (DR), hasil citra tetap optimal. Saran: Diharapkan agar pemeriksaan HSG terus mengikuti standar operasional prosedur (SOP) berbasis bukti ilmiah untuk menjamin keamanan pasien dan kualitas diagnostik. Penggunaan teknologi digital radiography (DR) dapat lebih dioptimalkan guna menghasilkan citra yang konsisten dan akurat, serta meminimalisir risiko komplikasi. Selain itu, penting untuk meningkatkan edukasi pasien mengenai persiapan pemeriksaan, memperkuat dokumentasi hasil, dan melakukan evaluasi berkala terhadap prosedur agar kesesuaian antara teori dan praktik tetap terjaga serta mendukung pelayanan radiologi yang berkualitas.