Introduction: The two diagnostic procedures used for evaluation of tubal patency in infertile couples are hysterosalpingography (HSG) and chromotubation under laparoscopy. Each procedure presents advantages, disadvantages and limitations. It often happens to observe some discrepancy between the two methods. The aim of our study is to compare the diagnostic accuracy of HSG and laparoscopy in the identification of tubal patency. Materials and methods: A total of seventy-five patients (mean age 33 years; min=21; max=45) were included in this study and examined between July 1st 1996 and and July 1st 1998 by HSG, followed by chromopertubation under laparoscopy after almost six months. All patients presented primary or secondary infertility of fifteen months’ duration. Women with anovulatory cycles or couples in whitch we diagnosed as having a severe male factor were excluded from this study. Results: 75 patients underwent HSG and then laparoscopy. We observed bilateral tubal patency respectively in 28 (37.3%) e 37 cases (49.3%), bilateral tubal blockage in 25 (33.3%) e in 15 cases (20.0%). HSG identified the right and left tube blocked respectively in 12 (16.0%) e 10 cases (13.3%), the laparoscopy in 11 (14.6%) e 12 cases ( 16.0%). Conclusion: The lower percentage of tubal patency observed by HSG could be explained by the state of the patient, who is not in a condition of complete relax, and by the contact with the contrast medium which could provoke a tubal spasm, causing a false positive tubal blockage detected by laparoscopy. If we consider the advantages and the disadvantages of each diagnostic procedure we indicate the HSG as a first diagnostic approach in the sudy of tubal patency. We suggest to our patients a laparoscopy only in the cases of uncertainty or of bilateral blockage diagnosed by HSG.
Predictive value of hysterosalpingography in 75 infertile patients subsequently treated by laparoscopy
MARCI, Roberto;
1999
Abstract
Introduction: The two diagnostic procedures used for evaluation of tubal patency in infertile couples are hysterosalpingography (HSG) and chromotubation under laparoscopy. Each procedure presents advantages, disadvantages and limitations. It often happens to observe some discrepancy between the two methods. The aim of our study is to compare the diagnostic accuracy of HSG and laparoscopy in the identification of tubal patency. Materials and methods: A total of seventy-five patients (mean age 33 years; min=21; max=45) were included in this study and examined between July 1st 1996 and and July 1st 1998 by HSG, followed by chromopertubation under laparoscopy after almost six months. All patients presented primary or secondary infertility of fifteen months’ duration. Women with anovulatory cycles or couples in whitch we diagnosed as having a severe male factor were excluded from this study. Results: 75 patients underwent HSG and then laparoscopy. We observed bilateral tubal patency respectively in 28 (37.3%) e 37 cases (49.3%), bilateral tubal blockage in 25 (33.3%) e in 15 cases (20.0%). HSG identified the right and left tube blocked respectively in 12 (16.0%) e 10 cases (13.3%), the laparoscopy in 11 (14.6%) e 12 cases ( 16.0%). Conclusion: The lower percentage of tubal patency observed by HSG could be explained by the state of the patient, who is not in a condition of complete relax, and by the contact with the contrast medium which could provoke a tubal spasm, causing a false positive tubal blockage detected by laparoscopy. If we consider the advantages and the disadvantages of each diagnostic procedure we indicate the HSG as a first diagnostic approach in the sudy of tubal patency. We suggest to our patients a laparoscopy only in the cases of uncertainty or of bilateral blockage diagnosed by HSG.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
