PENATALAKSANAAN PEMERIKSAAN HYSTEROSALPINGOGRAPHY (HSG) PADA KLINIS INFERTILITAS PRIMER DI INSTALASI RADIOLOGI RSU ‘AISYIYAH PONOROGO
DOI:
https://doi.org/10.51878/healthy.v5i3.10672Keywords:
Hysterosalpingography, Infertilitas Primer, Media KontrasAbstract
ABSTRACT
The female reproductive system plays an essential role in the fertilization process, which involves interactions between hormones and reproductive organs; therefore, disorders in organs such as the uterus and fallopian tubes may lead to infertility. This study aims to examine the examination procedure, the rationale for using 6 cc of contrast media, and the stepwise injection technique in hysterosalpingography for primary infertility cases at RSU ‘Aisyiyah Ponorogo. This study employed a qualitative method with a case study approach through observation, interviews, and documentation, with research subjects consisting of one patient with primary infertility and healthcare personnel directly involved in the examination procedure. The results indicate that the examination procedure includes patient preparation, instrument placement, and gradual injection of contrast media, resulting in clearer visualization of the uterine cavity and fallopian tube patency while reducing pain complaints compared to direct injection techniques. In addition, the use of 6 cc contrast media administered stepwise provides a more even distribution, thereby improving the accuracy of radiological interpretation. These findings suggest that the stepwise approach not only enhances image quality but also improves patient comfort during the procedure. Thus, hysterosalpingography with gradual administration of 6 cc contrast media is proven to be an effective and efficient diagnostic method for primary infertility that is more controlled and patient-oriented.
ABSTRAK
Sistem reproduksi wanita berperan penting dalam proses fertilisasi yang melibatkan interaksi hormon dan organ reproduksi, sehingga gangguan pada organ seperti uterus dan tuba falopi dapat menyebabkan infertilitas. Penelitian ini bertujuan untuk mengetahui prosedur pemeriksaan, alasan penggunaan media kontras 6 cc, serta teknik pemasukan bertahap pada pemeriksaan hysterosalpingography pada klinis infertilitas primer di RSU ‘Aisyiyah Ponorogo. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus melalui observasi, wawancara, dan dokumentasi, dengan subjek penelitian meliputi satu pasien infertilitas primer serta tenaga kesehatan yang terlibat langsung dalam prosedur pemeriksaan. Hasil penelitian menunjukkan bahwa prosedur pemeriksaan dilakukan melalui tahapan persiapan pasien, pemasangan alat, serta injeksi media kontras secara bertahap, yang menghasilkan visualisasi lebih jelas pada kavum uteri dan patensi tuba falopi serta mengurangi keluhan nyeri dibandingkan teknik injeksi langsung. Selain itu, penggunaan media kontras 6 cc secara bertahap memberikan distribusi kontras yang lebih merata sehingga meningkatkan akurasi interpretasi radiologis. Temuan ini mengindikasikan bahwa pendekatan bertahap tidak hanya meningkatkan kualitas citra, tetapi juga mendukung kenyamanan pasien selama prosedur berlangsung. Dengan demikian, prosedur hysterosalpingography dengan pemberian kontras bertahap 6 cc terbukti efektif dan efisien sebagai metode diagnostik infertilitas primer yang lebih terkontrol dan berorientasi pada pasien.
References
Amalia, A., Primindari, R. S., & Irawan, D. D. (2025). Pengaruh Inhalasi Aromaterapi Lavender Terhadap Tingkat Kecemasan Pada Wanita Infertil Dengan Pemeriksaan Hysterosalpingography (HSG). Jurnal Kesehatan Medika Udayana, 11(02), 149-160. https://doi.org/10.47859/jmu.v11i02.621
Amini, R., Utami, M. P., Utama, H. W., & Zanariah, Z. (2025). Kegiatan pemeriksaan histerosalpingografi (HSG) pada kasus infertilitas. JOURNAL of Public Health Concerns, 5(10), 721-728. https://doi.org/10.56922/phc.v5i10.2018
Canday, M., Yurtkal, A., & Kirat, S. (2023). Evaluation and perspectives on hysterosalpingography (HSG) procedure in infertility: a comprehensive study. European Review for Medical & Pharmacological Sciences, 27(15). https://doi.org/10.26355/eurrev_202308_33284
Chahine, R., Zadeh, C., Abou Zeid, F., & Al-Kutoubi, A. (2024). Hysterosalpingography: a step up for dose reduction. Clinical radiology, 79(1), e89-e93. https://doi.org/10.1016/j.crad.2023.10.001
Cue, L., Mayer, C., & Martingano, D. J. (2024). Hysterosalpingogram. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK572146/
Farida, R., & Hidayat, E. C. (2025). Identifying The Causes Of Infertility Through Imaging Procedures: A Case Report. International Journal of Radiology and Imaging, 4(01), 37-41. https://doi.org/10.21776/ub.ijri.2025.004.01.5
Geenen, R. W., Van Der Molen, A. J., Dekkers, I. A., Bellin, M. F., Bertolotto, M., Correas, J. M., ... & Brismar, T. B. (2024). Contrast media for hysterosalpingography: systematic search and review providing new guidelines by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. European radiology, 34(10), 6435-6443. https://doi.org/10.1007/s00330-024-10707-6
Han, T., Zhao, H., Lin, J., Gui, D., Mo, L., Li, Y., ... & Zhang, Q. (2025). Comparison of pregnancy and adverse events between infertile patients receiving X-ray hysterosalpingography and those receiving hysterosalpingo-contrast sonography: a prospective, multicenter, cohort study. Archives of Gynecology and Obstetrics, 312(6), 1957-1965. https://doi.org/10.1007/s00404-025-08102-7
Iloraah, U. S. (2025). Is Hysterosalpingography Still Relevant in Modern-day Female Infertility Work-up? A Review. International Journal of Research and Reports in Gynaecology, 8(1), 357-364. https://doi.org/10.9734/ijrrgy/2025/v8i1145
Kamal, E., & Elzaki, M. (2024). Hysterosalpingography findings in infertile Sudanese women: a cross-sectional study on tube blockage. The Pan African Medical Journal, 48, 62. https://www.panafrican-med-journal.com/content/article/48/62/full/
Kiridi, E. K., Oriji, P. C., Abasi, I. J., Ubom, A. E., & Ugwoegbu, J. U. (2022). Predictors of abnormal findings in infertile women undergoing hysterosalpingography in Bayelsa State, South-South Nigeria.Int J Clin Obstet Gynaecol, 6(2). 22-30. https://www.doi.org/10.33545/gynae.2022.v6.i2a.1159
Lumbangaol, A. I., Dewi, P. U., & Sudiatmika, D. G. M. (2025). Hysterosalpingography (HSG) Findings in Primary Infertility: Serial Cases. Qanun Medika-Medical Journal Faculty of Medicine Muhammadiyah Surabaya, 9(02). https://doi.org/10.30651/jqm.v9i02.24661
Mahendra, G., & Sahana, M. (2025). Comparative analysis of hysterosalpingography and diagnostic hysteroscopy findings in infertility evaluation. Cureus, 17(4). https://doi.org/10.7759/cureus.81789
Mathews, D. M., Peart, J. M., Sim, R. G., Johnson, N. P., O’Sullivan, S., Derraik, J. G., & Hofman, P. L. (2024). Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography: a prospective cohort study. Frontiers in Endocrinology, 15, 1257888. https://doi.org/10.3389/fendo.2024.1257888
Nako, Y., Ota, K., Sujino, T., Mitsui, J., Kamo, H., Katsumata, S., ... & Kawai, K. (2024). A large study about reproductive factors that predict hysterosalpingography-identified tubal pathology: an insight into the necessity of preconception screening. Journal of Clinical Medicine, 14(1), 179. https://doi.org/10.3390/jcm14010179
Nansih, L. A., Sari, O. P., Yudha, S., Rahmadianti, Y., & Ramadanni, D. S. (2024). Effectiveness Of Hysterosalpingography Examination With Clinical Infertility At The Radiology Installation In 2023. Jurnal Ilmu dan Teknologi Kesehatan, 15(1). https://doi.org/10.33666/jitk.v15i1.608
Roest, I., Rosielle, K., van Welie, N., Dreyer, K., Bongers, M., Mijatovic, V., ... & Koks, C. (2021). Safety of oil-based contrast medium for hysterosalpingography: a systematic review. Reproductive BioMedicine Online, 42(6), 1119-1129. https://doi.org/10.1016/j.rbmo.2021.03.014
Simamora, D., & Ariyanti, S. (2023). Radiography Hystero Salpingography (HSG) With the Allegation of Nonpatency of Both Fallopii Tubes at Columbia Asia Hospital Medan. Journal Homepage: https://ejournal. ipinternasional. com/index. php/ijphe, 3(1), 339-346. https://doi.org/10.55299/ijphe.v3i1.675
Sitanggang, F. P., Patriawan, P., Dos Santos, R. P., Caroline, A., & Wardani, G. A. (2024). Characteristics of Hysterosalphingography Findings in Infertile Patients at Prof. Dr. IGNG Ngoerah Central Hospital at Periode of January 2021 to June 2024. Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan, 18(2), 180-191. https://doi.org/10.33533/jpm.v18i2.9553
Tian, W., Xie, B., Liang, F., Huang, Y., Hu, Q., Yu, J., & Qin, A. (2025). Comparative analysis of hysterosalpingography and hysterosalpingo-contrast sonography for assessing tubal patency in women with endometriosis-related infertility: a propensity score-matched study. Archives of Gynecology and Obstetrics, 312(2), 505-513. https://doi.org/10.1007/s00404-025-08008-4
Tsui, S., & Sofy, A. A. (2023). A meta-analysis of fertility and adverse outcomes in oil-and water-based contrast for hysterosalpingography. Turkish journal of obstetrics and gynecology, 20(1), 64. https://doi.org/10.4274/tjod.galenos.2023.67750
Usta, A., Usta, C. S., Lafci, D., Kiris, T., & Avci, E. (2024). Contrast induced nephropathy in women with infertility undergoing hysterosalpingography. Reproductive Biology and Endocrinology, 22(1), 156. https://doi.org/10.1186/s12958-024-01334-3
Wahyudiasa, M. R., Wulandari, P. I., Susanta, I. P. A., & Dimpudus, F. J. (2023). Analisis Penggunaan Media Kontras Pada Pemeriksaan Radiologi Intervensi Percuataneous Coronary Intervention Di Rsup Prof. Dr. Igng Ngoerah Denpasar. Jurnal Ilmu Kedokteran dan Kesehatan, 10(11), 3228-3236. https://doi.org/10.33024/jikk.v10i11.12144
Wang, T., Dong, T., & Nie, F. (2025). Clinical applications, advances, and future directions in hysterosalpingography. Frontiers in Medicine, 12, 1537506. https://doi.org/10.3389/fmed.2025.1537506
Zilviana, R., Dewi, S. N., & Putri, M. N. (2024). Studi kasus pemeriksaan hysterosalpingography (HSG) pada klinis infertilitas primer di instalasi radiologi RSU Islam Klaten. In Prosiding Seminar Nasional Penelitian dan Pengabdian Kepada Masyarakat LPPM Universitas' Aisyiyah Yogyakarta, 2. 694-700. https://proceeding.unisayogya.ac.id/index.php/prosemnaslppm/article/view/489














