Hysterosalpingography in the assessment of proximal tubal pathology: a review of congenital and acquired abnormalities

2021 ◽  
pp. 20201386
Author(s):  
Fatemeh Zafarani ◽  
Firouzeh Ghaffari ◽  
Firoozeh Ahmadi ◽  
Malek Soleimani Mehranjani ◽  
Golam Shahrzad
Keyword(s):  
Minimal Risk ◽  
Fallopian Tubes ◽  
Peritoneal Disease ◽  
Saline Infusion Sonography ◽  
Tubal Patency ◽  
Performance Accuracy ◽  
Structural Abnormalities ◽  
Tubal Lumen ◽  
Acquired Abnormalities ◽  
Tubal Pathology

Tubal and peritoneal disease are the main causes of infertility. Tubal pathology can be either congenital malformation or acquired, proximal or distal, unilateral or bilateral and transient or permanent. Several imaging methods such as laparoscopy, fluoroscopy, saline infusion sonography, and hysterosalpingography (HSG) have been used in the assessment of tubal and peritoneal pathology. Although laparoscopy is the modality of choice for investigating tubal patency and pelvic structure in many infertility centers, HSG is usually the initial diagnostic method for infertility workup because of its ease of performance, accuracy, and minimal risk of complications. This method provides useful information about size, contour, and anatomy of the inner surface of the fallopian tubes and is the gold standard for evaluation of tubal lumen. Tubal and peritubal pathology show various imaging manifestations on HSG. This review illustrates the radiographic features of congenital and acquired structural abnormalities of the proximal tubal pathology and along with etiology of proximal obstruction or occlusion will be described.

A STUDY ON THE ROLE OF SALINE SONOSALPINGOGRAPHY AS A TEST FOR TUBAL PATENCY IN THE ASSESSMENT OF INFERTILITY

2021 ◽  
pp. 80-82
Author(s):  
Bishnu Prasad Das ◽  
Manoj Kumar Majumdar ◽  
Chumi Deka
Keyword(s):  
Predictive Value ◽  
High Sensitivity ◽  
Fallopian Tubes ◽  
Perfect Agreement ◽  
Tubal Patency ◽  
Primary Health ◽  
Infertility Patients ◽  
Work Up ◽  
Tubal Pathology

Background: Tubal pathology is one of the major causes of infertility and evaluation of fallopian tubes forms an essential part of work up of infertility patients. The aim of the study was to evaluate tubal patency by Saline Sonosalpingography and compare the results with that of hysterosalpingography. Methods: A total of 22 patients with primary infertility and 13 patients with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from July 2019 to June 2020. All the study subjects underwent Saline Sonosalpingography on day 7 to day 9 and Hysterosalpingography on 7th to 11th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specicity of Sonosalpingography with Hysterosalpingography as reference standard. Results: Sonosalpingography (SSG) has 98.18% sensitivity and 66.67% specicity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 91.52% and negative predictive value of 90.9%. Near perfect agreement (Cohen's Kappa coefcient =0.9) was seen between the results of the two methods (SSG and HSG). Conclusions: Sonosalpingogrpahy has a high sensitivity for tubal patency and is less invasive. It is found to be a reliable and relatively less expensive diagnostic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centres denitely can prove superior to conventional method of diagnosis of tubal patency in such patient.

EVALUATION OF HYSTEROSALPINGOGRAPHY VERSUS LAPAROSCOPY IN THE DETERMINATION OF TUBAL FACTORS IN FEMALE INFERTILITY: A HOSPITAL BASED COMPARATIVE STUDY.

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Richa Choudhary ◽  
Rishikant Sinha
Keyword(s):  
Female Infertility ◽  
Diagnostic Methods ◽  
Panoramic View ◽  
Tubal Patency ◽  
Pelvic Organs ◽  
Clinical Investigations ◽  
Detailed Assessment ◽  
Reproductive Anatomy ◽  
Tubal Pathology

Objectives: Hysterosalpingography and laparoscopy both are the diagnostic methods for assessment of female infertility.  The present study was to compare the evaluation of hysterosalpingography (HSG) versus laparoscopy in determination of tubal factors in female infertility. Methods: Detailed assessment, physical examination and clinical investigations were performed in all 100 infertile female with age 20 years to 40 years. All patients were advised to perform digital HSG. Patients with an abnormal HSG underwent laparoscopy without delay, whereas in patients with a normal HSG, laparoscopy was performed three months after HSG. HSG is best scheduled during the 2nd -5th day interval immediately following the end of menstruation, to minimize risk for infection, avoid interference from intrauterine blood and clot, and to prevent any possibility that the procedure might be performed after conception. Results: Data was analysed by using IBM SPSS version 23 software.  All data was tabulated and percentages were calculated. Mean ± standard deviation was observed. Conclusions: Diagnostic laparoscopy is the gold standard in diagnosing tubal pathology and other intra-abdominal causes of infertility. Other hand, Hysterosalpingography is a frequently utilized diagnostic tool in the assessment of tubal status and detection of uterine anatomical defects in infertility. Hysterosalpingography and laparoscopy are not alternatives but complimentary investigations. But, inadequacy of hysterosalpingography (HSG) in determining the state of tubal patency, emphasizes the need for laparoscopy. Laparoscopy provides both a panoramic view of the pelvic reproductive anatomy and a magnified view of pelvic organs and peritoneal surfaces. Keywords: Female infertility, Tubal patency, HSG, Laparoscopy

3D and 4D studies from human reproduction to perinatal medicine

2017 ◽  
Vol 45 (6) ◽  
Author(s):  
Sonal Panchal ◽  
Asim Kurjak ◽  
Chaitanya Nagori
Keyword(s):  
Prenatal Diagnosis ◽  
Congenital Malformations ◽  
Three Dimensional ◽  
Endometrial Receptivity ◽  
Human Reproduction ◽  
Fallopian Tubes ◽  
Perinatal Medicine ◽  
Tubal Patency ◽  
Pretreatment Assessment

AbstractThree-dimensional ultrasound (3D US) is a modality of choice for prenatal diagnosis of congenital malformations. But 3D-four-dimensional US(4D US) is of utmost importance also to achieve pregnancy. 3D US plays an important role for diagnosis of PCO, to assess ovarian reserve and response and thus to decide optimum stimulation protocols. It adds to the information on follicular maturity and endometrial receptivity, thus improving the chances to achieve pregnancy for patients under treatment for fertility. 3D hystero-contrast-salpingography (HyCoSy) has also proved itself to be one of the best modalities for assessment of tubal patency. In this article, the role of 3D and 4D US is discussed for the following. I. Pretreatment assessment of the females desiring fertility which includes assessment of uterus and fallopian tubes. II. Monitoring of infertile females undergoing treatment. III. Assessment of very early pregnancy – especially in abnormal locations.

scholarly journals ROLE OF HYSTEROSALPINGOGRAPHY IN MANAGEMENT OF FEMALE INFERTILITY AND ITS LAPAROSCOPIC CORRELATION

2019 ◽  
pp. 1-2
Author(s):  
(prof.) Alka Agrawal
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Radiographic Technique ◽  
Invasive Techniques ◽  
Work Up ◽  
Tubal Pathology

BACKGROUND : Infertility nowadays has become a medical as well as social problem.Laboratory findings alone is inconclusive in diagnosing infertility.HSG is the radiographic technique for evaluation of uterine cavity & fallopian tubes..Direct visualization of abdominal and pelvic organs in laparoscopy allows a definite diagnosis where clinical examination & less invasive techniques such as ultrasound & HSG fail to identify the abnormality. AIMS & OBJECTIVES :To determine the role of HSG in the evaluation of infertility & to correlate its findings with laparoscopy. METHODS : 75 infertile females aged between 20-40 years were included. HSG & laparoscopy was performed in all patients & findings were analysed. RESULTS : Sensitivity of HSG was 80 %,specificity was 76 % with positive predictive value 63%, negative predictive value 88 % in detecting tubal pathology. Sensitivity of HSG in detecting uterine pathology was 67%, specificity 73%, positive predictive value 39% and negative predictive value 89%. CONCLUSION : HSG has reasonably good sensitivity & specificity in diagnosing tubal & uerine pathology while laparoscopy has diagnostic as well as therapeutic approach.Hence they are complimentary to each other in infertility work up.

scholarly journals A petevezeték-átjárhatóság vizsgálómódszereinek összehasonlító elemzése

2017 ◽  
Vol 158 (9) ◽  
pp. 324-330 ◽  
Author(s):  
Judit Lőrincz ◽  
Attila Jakab ◽  
Péter Török
Keyword(s):  
Direct Method ◽  
Standard Procedure ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Fallopian Tubes ◽  
Predictive Values ◽  
Tubal Patency ◽  
First Choice

Abstract: Most common organic cause of infertility is the blockage of the Fallopian tubes. Several methods were introduced to evaluate tubal patency. Hysterosalpingography is a conventional radiology procedure using contrast medium, which gives an accurate image of the uterine cavity and the Fallopian tubes, but radiation exposure is necessary. Hystero-contrast-sonography similarly examines the uterine cavity and tubal patency by ultrasonography, and it enables to detect pelvic pathology, too. Transvaginal hydrolaparoscopy is a minimal invasive direct method using endoscope introduced into the abdominal cavity through the posterior vaginal fornix, both ovaries and tubal patency can be observed. Laparoscopy is the “gold standard” procedure in the tubal testing, however it is a more invasive procedure. A cost-effective testing method is the selective tubal pertubation performed via office hysteroscopy. Recent outpatient methods to detect tubal patency have high negative predictive values and recommended to be the first choice in infertility work-up. Orv. Hetil., 2017, 158(9), 324–330.

scholarly journals African experience of hysterosalpingography abnormalities tubes management by laparoscopy in infertile women

2019 ◽  
Vol 8 (11) ◽  
pp. 4271
Author(s):  
Mohamed Fanny ◽  
Edele Aka ◽  
Perel Konan ◽  
Luc Olou ◽  
Abdoul K. Koffi ◽  
...  
Keyword(s):  
Pelvic Surgery ◽  
Fallopian Tubes ◽  
Tubal Infertility ◽  
Tubal Patency ◽  
Infertile Women ◽  
African Experience ◽  
Gynecology And Obstetrics ◽  
Therapeutic Procedures ◽  
History Of ◽  
Sub Saharan

Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.

Comparison between magnetic resonance hysterosalpingography and conventional hysterosalpingography: direct visualization of the fallopian tubes using a novel MRI contrast agent mixture

2019 ◽  
Vol 61 (7) ◽  
pp. 1001-1007 ◽  
Author(s):  
Na Duan ◽  
Xiao Chen ◽  
Yanyun Yin ◽  
Zhongqiu Wang ◽  
Rong Chen
Keyword(s):  
Magnetic Resonance ◽  
Contrast Agent ◽  
Female Infertility ◽  
Observer Agreement ◽  
Mri Contrast Agent ◽  
Fallopian Tubes ◽  
Mri Contrast ◽  
Predictive Values ◽  
Tubal Patency ◽  
Mr Scanning

Background Magnetic resonance hysterosalpingography (MR-HSG) is a promising technique in the work-up of female infertility. Few existing MR-HSG studies focus on the comparison between MR-HSG with gold standard examination. Purpose To compare the diagnostic value of MR-HSG with conventional HSG in patients receiving both exams in one day. Material and Methods This study included 33 infertile women who completed pelvic MR scanning, HSG, and MR-HSG in that order. A traditional HSG contrast agent (iohexol) and a magnetic resonance imaging (MRI) contrast agent (1 mL gadopentetate dimeglumine (Gd-DTPA) blended with 100 mL iohexol) were used to achieve image enhancement. Inter-observer and inter-modality agreements of HSG and MR-HSG exams were assessed. The results were calculated by using the kappa test. Three radiologists who were blinded to the clinical data independently reviewed the MR images. Extratubal abnormalities were analyzed. Results A total of 62 fallopian tubes of 33 women were included in the study. MR-HSG imaging findings to depict tubal patency were similar to these of HSG (AUC 0.911, sensitivity 0.821, specificity 1.000, positive predictive values 1.000, and negative predictive values 0.872). Pairwise inter-observer agreement among three observers and inter-modality agreement of the diagnosis were excellent (mean kappa 0.863 and 0.835, respectively). In addition, 29 extratubal abnormalities in 21 patients were found on pelvic MR scanning. Conclusion MR-HSG and HSG demonstrated similar results in assessing tubal patency. Because it offers the comprehensive assessment of female pelvic structures, and avoids ionizing radiation, MR-HSG may be used as an alternative imaging technique for evaluation of female infertility.

scholarly journals Role of Hysterosalpingography for Evaluation of Infertility

1970 ◽  
Vol 39 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Shahara Haque
Keyword(s):  
Medical Journal ◽  
Diagnostic Tool ◽  
False Positive ◽  
False Negative ◽  
Uterine Cavity ◽  
Age Group ◽  
Fallopian Tubes ◽  
Potential Accuracy ◽  
Tubal Pathology

The patients investigated under this study have complaints of inability to conception and they were not responding to treatment. Patients with infertility were studied, the peak incidence of infertility was found in between 26-29 years of age group. Hysterosalpingography examination detected tubal and uterine pathology correctly in 26 cases (81.25%) out of 29 cases of complaining of infertility. Of 18 negative cases, 12 cases (80%) are diagnosed correctly as normal by Hysterosalpingography. After laparoscopic examination it was established that three (20%) were false positive and 6 cases were false negative. If a longer series are analyzed, these findings may vary slightly but still it is very useful diagnostic tool for detection of infertility. Hysterosalpingography will give utmost benefit to the patients of our country. In our study we found that Hysterosalpingography is still the best technique for intrauterine and tubal pathology. This study has established the fact that Hysterosalpingography should be the first approach in the diagnosis of infertility which gives valuable information about both uterine cavity and fallopian tubes at low risk and minimal hazards. As a result of our findings, it is our investigation of female infertility due to its potential accuracy and easy performance Keywords: Hysterosalpingography; Infertility. DOI: 10.3329/bmj.v39i1.6228 Bangladesh Medical Journal 2010; 39(1): 16-23

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