A petevezeték-átjárhatóság vizsgálómódszereinek                     összehasonlító elemzése

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.

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Comparative evaluation of hysterosalpingo contrast sonography with laparoscopy for determination of tubal patency in infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201797 ◽

2020 ◽

Vol 9 (5) ◽

pp. 2009

Author(s):

Geetha Krishnamoorthy ◽

Amutha Perumal ◽

Chithra Boovaragasamy ◽

Gnanamani Gnanasabai

Keyword(s):

Screening Method ◽

Uterine Cavity ◽

Invasive Procedure ◽

Cost Effective ◽

Cross Sectional Study ◽

Cross Sectional ◽

Tubal Patency ◽

Infertile Women ◽

Additional Information ◽

History Of

Background: Tubal factor is responsible for infertility and is found in one of three infertile women. The current research was undertaken to compare the efficacy of hysterosalpingo contrast sonography (HyCoSy) with laparoscopy and chromopertubation in infertile women.Methods: A cross-sectional study was conducted from August 2016 to March 2017 among the patients attending outpatient department with complaints of primary or secondary infertility after obtaining written and informed consent. Detailed history of the patient was taken; clinical examination and necessary investigations were done. Data analysis was carried out using SPSS version 22.Results: All the HyCoSy findings showed excellent specificity (84-100%) and the sensitivity ranged from 40-87%.Conclusions: Study conclude that HyCoSy is a good screening method for evaluating uterine cavity lesions and tubal block in infertile women being safe, sensitive, cost effective, non-invasive procedure giving additional information regarding ovarian, adnexal and peritoneal pathology.

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Correlation of fine needle aspiration cytology and histopathology of neck swellings

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180986 ◽

2018 ◽

Vol 4 (3) ◽

pp. 648

Author(s):

C. S. Asha ◽

B. R. Suchit Roy

Keyword(s):

Salivary Gland ◽

Lymph Node ◽

Predictive Value ◽

Age Groups ◽

Invasive Procedure ◽

High Specificity ◽

Cost Effective ◽

Needle Aspiration ◽

Predictive Values ◽

Specificity And Sensitivity

Background: Neck swellings are a common clinical finding affecting all age groups. FNAC is a minimally invasive procedure helpful in the diagnosis of various neck swellings. The purpose of this study is to determine the accuracy of FNAC in the diagnosis of neck swellings by comparing it with the histopathology which is taken as the gold standard.Methods: A prospective study which included 90 patients who attended ENT and surgery departments of Government Medical College, Trivandrum with neck swellings from July 2006-2007. FNAC of the swelling was done and the FNAC results were compared with the histopathology results. The specificity, sensitivity, positive and negative predictive values and accuracy of FNAC were calculated. Results: Of the 90 patients, thyroid swelling formed the major group followed by lymph node, salivary gland and miscellaneous swellings. Thyroid swellings had a female predominance while the other three groups namely lymph node, salivary gland and miscellaneous groups showed a male preponderance. When the neck swellings namely thyroid, salivary gland, lymph node and miscellaneous group were taken into consideration as a whole, the sensitivity of FNAC for detecting malignancy was 64.3%. The specificity, positive predictive value, negative predictive value and accuracy were 97.4%, 81.8%, 93.7% and 92% respectively.Conclusions: FNAC can be rated as a safe, simple, reliable, cost effective and rapid diagnostic tool with high specificity and sensitivity for the initial evaluation of neck swellings.

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Accuracy of a new hysteroscopic method in the assessment of tubal patency: Hysteroscopic Chromotubation

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2017.692 ◽

2018 ◽

Vol 24 (2) ◽

pp. 82

Author(s):

Burak Yucel ◽

Emine Demirel ◽

Sefa Kelekci ◽

Kerem Doga Seckin ◽

Osama Shawki

Keyword(s):

Methylene Blue ◽

Cohort Study ◽

Gold Standard ◽

Uterine Cavity ◽

High Sensitivity ◽

Office Hysteroscopy ◽

Predictive Values ◽

Tubal Patency ◽

Infertile Women ◽

Sensitivity Specificity

ObjectiveThe aim of this study was to evaluate the diagnostic accuracy of hysteroscopic chromopertubation (HCT) in the assessment of tubal patency by comparing its results with laparoscopic chromopertubation (LCT).Study DesignThe population of this prospective cohort study consisted of both fertile and infertile women. Sixty-four women were included to the study. HCT was assessed by the observation of the transport of highly concentrated methylene blue from uterine cavity to tubal ostia. The results of HCT were compared with the results of LCT as a gold standard. The accuracy of HCT, sensitivity, specificity, positive and negative predictive values in diagnosing tubal patency were calculated.ResultsThe results of HCT and LCT were evaluated for right and left tubes, separately. One hundred and twenty-eight tubes were determined. Sensitivity, specificity, positive and negative predictive values for HCT were; 85.85%, 59.09%, 91% and 46.43%, respectively.Conclusion This study’s result showed that HCT had high sensitivity and moderate specificity values in the assessment of tubal patency. HCT during office hysteroscopy could give the chance to practitioners to assess tubal patency without subjecting the patient to multiple procedures.

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

Acta Radiologica ◽

10.1177/0284185119883712 ◽

2019 ◽

Vol 61 (7) ◽

pp. 1001-1007 ◽

Cited By ~ 1

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.

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Infrahepatic Implantation of an Ectopic Pregnancy

Surgical Case Reports ◽

10.31487/j.scr.2021.03.16 ◽

2021 ◽

pp. 1-3

Author(s):

Peter Kern ◽

Paula Ulrich ◽

Rainer Kimmig ◽

Peter Kern

Keyword(s):

Ectopic Pregnancy ◽

Close Contact ◽

Blood Clot ◽

Abdominal Cavity ◽

Uterine Cavity ◽

Greater Omentum ◽

Free Fluid ◽

Fallopian Tubes ◽

Lower Abdomen ◽

The Right

Background: Ectopic pregnancies occur predominantly in the fallopian tubes or ovaries. Very rarely, the distal part of the greater omentum may have close contact to the fallopian tubes and implantation of the embryo may occur in this part of the greater omentum. In the absence of signs of pregnancy in the uterus or the fallopian tubes, the greater omentum has to be closely examined for ectopic pregnancy. Case Presentation: A 22-year-old woman in her 4th week of pregnancy presents with spotting and severe pain in the right lower abdomen with a history of 2 cesarean sections. The sonographic examination showed a normal uterus with a thin endometrial line. The uterine cavity did not present with any signs of a gestational sac. A great amount of free fluid in the Douglas cavity suspicious of a hemoperitoneum. ßhCG-values in serum was highly elevated up to 16749 mU/ml and confirmed the suspicion of an ectopic pregnancy. A diagnostic laparoscopy was performed, during which a blood clot reaching from the right lower abdomen to the greater omentum was detected. After removing the blood clot, a normal-sized uterus with regular ovaries and no signs of a pregnancy in the fallopian tubes were seen. However, an abdominal adhesion in the right upper part of the omentum close to the liver with bleeding was seen. While examining the abdominal cavity for the cause of bleeding, a small cystic lesion adherent to the greater omentum – close the offspring from the colon – representing an ectopic pregnancy became apparent. A partial omentectomy of 9,5 cm x 5,5 cm x 2,5 cm was performed with the finding of trophoblast and embryoblast implantated in the infrahepatic part of the greater omentum. Conclusion: In cases of ectopic pregnancy with hemoperitoneum, special care has to be taken examining not only the fallopian tubes or ovaries but also the greater omentum, which may harbour an implanted trophoblast and embryoblast – even in the upper part directly beneath the liver – as presented in this case. In cases of ruptured ectopic pregnancy of the greater omentum, the cases may be dealt with laparoscopic partial omentectomy if the case is early detected.

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Role of Radiographic Hysterosalpingography in Infertility in Eastern Nepal

Nepalese Journal of Radiology ◽

10.3126/njr.v3i1.8810 ◽

2013 ◽

Vol 3 (1) ◽

pp. 59-66

Author(s):

Pranav Kumar Santhalia ◽

MK Gupta ◽

D Uprety ◽

K Ahmad ◽

S Ansari ◽

...

Keyword(s):

Uterine Cavity ◽

Image Intensifier ◽

Cost Effective ◽

Cross Sectional Study ◽

Vital Role ◽

Female Infertility ◽

Imaging Features ◽

Fallopian Tubes ◽

Cross Sectional ◽

Ionic Contrast

Background: Hysterosalpingography (HSG) is the radiographic technique for evaluation of uterine cavity and fallopian tubes. It still remains the best imaging procedure for fallopian tubes despite the advent of newer modalities and is used primarily for the evaluation of female infertility.1,2 The purpose of the study was to assess the uterine and tubal abnormalities detected on radiographic HSG as causative factors of infertility and to describe their imaging features. Methods: This prospective cross sectional study was conducted at the Department of Radiodiagnosis and Imaging, BPKIHS, Dharan. Forty-four patients with infertility (both primary and secondary) referred for HSG were included. HSG was performed using non-ionic contrast medium under image intensifier fluoroscopic control during the follicular phase of menstrual cycle. Radiographic films were obtained and analyzed. Results: Out of the total 44 patient, 26 (59.0%) had primary infertility while 18 (41.0%) had secondary infertility. Tubal abnormalities were seen in 28 (63.6%) and uterine abnormalities in 2 (4.6%) patients. The most common tubal abnormality detected on HSG was tubal block (50.0%). Unilateral and bilateral tubal blocks were equally distributed (50.0% each). Proximal tubal block was observed in 8 (36.4%) and distal in 13 (59.1%) patients. Fifteen (34.1%) patients had hydrosalpinx. Conclusion: HSG is easy, safe, and cost-effective and plays vital role in the evaluation of female with infertility. The most common structural cause of female infertility found as per this study was tubal block. Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 59-66 DOI: http://dx.doi.org/10.3126/njr.v3i1.8810

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ROLE OF CONVENTIONAL HYSTEROSALPINGOGRAPHY IN THE WORK UP OF FEMALE INFERTILITY IN RURAL TERTIARY CARE HOSPITAL, INDIA

10.36106/ijsr/9405832 ◽

2021 ◽

pp. 4-9

Author(s):

P Lakshmi ◽

V Venkatarathnam ◽

Ramesh Kumar

Keyword(s):

Tertiary Care Hospital ◽

Social Stigma ◽

Tertiary Care ◽

Invasive Procedure ◽

Cost Effective ◽

Female Infertility ◽

Care Hospital ◽

Tubal Patency ◽

Study Results ◽

Tubal Blockage

Background: Infertility is a major problem throughout the world. In a country like India, it is associated with a social stigma. The cause can be multifactorial and many couples are seeking medical help for infertility nowadays. As part of the female infertility workup, hysterosalpingography plays an important role. Methods And Material: A retrospective study was done in the department of Radiodiagnosis of a rural tertiary care hospital, India. All patients who were referred for hysterosalpingography study as part of infertility workup between January 2018 and December 2020 to the department of Radiodiagnosis were included in the study. Results: A total of 173 patients are included in the study. Out of these 173 patients, 3 women had repeat Hysterosalpingography studies. 43.2% of these studies are abnormal. 56.8% cases showed normal ndings. Tubal abnormalities were the most common accounting for 34.6% of the total studies. Uterine abnormalities were seen in 6.8% of the total studies. Both fallopian tube and uterine abnormalities were seen in 1.7%. Post-operative follow-up imaging was available for 3 patients. All three patients had a bilateral tubal block in the rst study and showed tubal patency in post recanalization HSG study. Conclusion: Hysterosalpingography is a lesser invasive procedure, cost-effective, and does not require anesthesia compared to laparoscopy. This is a huge advantage, especially in a rural setup. It can be considered as a screening investigation along with an ultrasound examination. Tubal blockage is the most common abnormality accounting for nearly one-third of the causes of infertility in our study. Tuberculosis should always be ruled out as a cause of tubal blockage in India where it is more prevalent.

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Unsual Tubal Twin Ectopic Gestation Report of Three Different Cases

Journal of Clinical Cases & Reports ◽

10.46619/joccr.2018.1-1019 ◽

2018 ◽

Vol 1 (3) ◽

pp. 96-103

Author(s):

S Gosavi Maheshgir ◽

Keyword(s):

Ectopic Pregnancy ◽

Abdominal Cavity ◽

Uterine Cavity ◽

Rare Condition ◽

Fallopian Tubes ◽

Tubal Ectopic Pregnancy ◽

Ectopic Gestation ◽

First Case ◽

History Of ◽

Twin Pregnancies

Gestation outside the uterine cavity in which the implantation occurs in any tissue other than the endometrium is referred as ectopic pregnancy. The most places for occurring ectopic pregnancy (97% of cases) are the fallopian tubes including ampulla (55%), isthmus (25%), and fimbria (17%), and in 3% of patient’s ectopic pregnancy occurs in the abdominal cavity, ovary, or cervix. The tubal twin ectopic pregnancy is a rare condition, and the first unilateral tubal twin was reported by De Ott in 1891, and the first live twin tubal ectopic pregnancy was reported in 1944. A live tubal twin ectopic pregnancy is a very rare condition and among >100 reports of tubal twin pregnancies, till now, only 8 cases were live. Early diagnosis and treatment of women with tubal twin ectopic pregnancy is very important and may decrease the risk of tubal rupture. I present three cases of tubal twin ectopic gestation. In the first case, spontaneous unilateral live tubal twin ectopic gestation. The second and third cases spontaneous ruptured twin ectopic gestation. All three cases were successfully managed and there was no history of assisted reproductive techninique fertilization or pelvic inflammatory disease.

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ASSESSMENT OF ANATOMICAL & FUNCTIONAL SUCCESS IN EXTERNAL DACRYOCYSTORHINOSTOMY BY AIR BUBBLE TEST

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i9.535 ◽

2019 ◽

Vol 3 (9) ◽

Author(s):

Dr. Vikas Tantuway

Keyword(s):

Case Series ◽

Invasive Procedure ◽

Nasolacrimal Duct ◽

Good Tool ◽

Predictive Values ◽

Reliability Indices ◽

Air Bubble ◽

Bubble Test ◽

External Dacryocystorhinostomy ◽

Anatomical Success

Aim: To assess reliability indices of Air Bubble Test (ABT) for anatomical and functional success in external Dacryocystorhinostomy (DCR). Methods: Prospective case series of nasolacrimal duct obstruction underwent DCR. Functional success defined as Munk score 0 & 1 & anatomical success as free irrigation at followup.ABT performed by putting antibiotic drops into eye& asking patient to exhale while keeping nose & mouth closed. Formation of bubbles at punctum considered as positive test. Specificity, sensitivity, positive & negative predictive values calculated. Results: There were 103 DCR in 97 patients(23 male,74 female)with mean age 45.56 yr. Anatomical and functional success was 99.02% & 98.05%, respectively.ABT showed sensitivity 96.07%, specificity 100% for anatomical success after DCR. Sensitivity and specificity were 97.02% & 100% for functional success. Conclusion: As non-invasive procedure ABT is a good tool to assess success of DCR, though lacrimal syringing remains the gold standard. Keywords: Anatomical, Dacryocystorhinostomy & Air Bubble Test.

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ECTOPIC PREGNANCY WITH ACCEPTOR IMPLANT

JOURNAL OBGIN EMAS ◽

10.25077/aogj.3.1.48-55.2019 ◽

2019 ◽

Vol 3 (1) ◽

pp. 48-55

Author(s):

Putri Zelfitri Zen ◽

Yusrawati Yusrawati

Keyword(s):

Ectopic Pregnancy ◽

Contraceptive Use ◽

Abdominal Cavity ◽

Uterine Cavity ◽

Hormonal Contraceptive ◽

Obstetrics And Gynecology

Objective: To report a case of Ectopic pregnancy with implant receptorsMaterials and Methods: This article describes the case of a 41-year-old woman, diagnosed with an Ectopic Pregnancy on the gravid G5P4A0H4 11-12 weeks. Patients are using implant contraception, which has been used since 2009-2018 (3 installations). The patient came to the obstetrics and gynecology clinic Dr. M. Djamil Padang. The ultrasound gives the impression of Ectopic pregnancy in the infindibule tube. Analysis Ectopic pregnancy can also occur due to the influence of hormonal contraceptive use (progesterone).Results: Patient gets intervention performed laparotomy After the peritoneum is opened it appears fresh red blood amounting to ± 500 cc filling the abdominal cavity. Blood evacuation and exploration are performed, it appears that the source of bleeding originates from the left tubal rupture (Infundibulum) Impression of the left tubal rupture (Infundibulum) ecectic ectopic pregnancy is impaired. Sinistal salpingectomy is performed.Conclusion: Ectopic pregnancy Ectopic pregnancy is all pregnancies where the ovum fertilized by spermatozoa implant and grows outside the uterine cavity endometrial.

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