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At least 181 records · Page 10Linked to original sources
PubMed2003

Unsuspected pregnancy at hysterosalpingography: a report of three cases with different outcomes.

We report three cases of unsuspected pregnancy during hysterosalpingography (HSG) with different outcomes. In the first two cases, menstrual history was wrongly relied upon and no pregnancy tests had been performed. However, even with a negative pregnancy test carried out prior to the investigation, as in the third case, this was proven not to be foolproof. The outcome of our pregnancies involves one ectopic, one miscarriage and one normal term pregnancy. We advocate not relying solely on menstrual history and to be aware that even in cases where there is a negative pregnancy test before HSG, the patient can still be pregnant. Although the reporting of unsuspected pregnancy during HSG is rare, there is still a need to be alert, especially in high-risk patients with irregular, long menstrual cycles and unprotected intercourse prior to the investigation.

Abdominal Pain↗
PubMed2006

Routine use of hysterosalpingography prior to laparoscopy in the fertility workup: a multicentre randomized controlled trial.

BACKGROUND: A multicentre randomized controlled trial with or without hysterosalpingography (HSG) was conducted to assess the usefulness of HSG as a routine investigation in the fertility workup prior to laparoscopy and dye. METHODS: From 1 April 1997 to 1 April 2002, subfertile women were allocated by a computer-based 1 : 1 ratio randomization procedure, either for an HSG followed by laparoscopy and dye (the intervention group) of for laparoscopy and dye only (the control group) as a part of their fertility workup. Cumulative pregnancy rate (CPR) within 18 months after randomization was the primary outcome of interest. RESULTS: 344 women were randomized to the intervention group (n = 169) and the control group (n = 175). There was no significant difference in CPR at 18 months in the intervention group (49.1%) [95% confidence interval (CI) 41.6 to 56.6] and the control group (50.3%) (95% CI 42.8 to 57.8), a difference of -1.2% (95% CI -11.8% to 9.5%). CONCLUSION: The routine use of HSG at an early stage in the fertility workup prior to laparoscopy and dye does not influence CPR, compared with the routine use of laparoscopy and dye without HSG.

Adult↗
PubMed1996

Reproducibility of the interpretation of hysterosalpingography in the diagnosis of tubal pathology.

The aim of the study was to estimate the inter- and intra-observer reproducibility of the interpretation of hysterosalpingography (HSG) in the diagnosis of tubal pathology, and associate reproducibility with diagnostic accuracy. Four observers evaluated 143 HSGs twice, on proximal tubal obstruction, distal tubal obstruction, hydrosalpinx and peritubal adhesions. Diagnostic laparoscopy with chromopertubation was considered to be the reference strategy. Reproducibility (inter- and intra-observer agreement) was expressed in terms of kappa-values. Accuracy was expressed in terms of sensitivity, specificity and likelihood ratios. kappa-values for reproducibility between observers were almost perfect for proximal obstruction, substantial for distal obstruction and hydrosalpinx, and moderate for adhesions. kappa-values for reproducibility within observers were almost perfect for proximal obstruction and substantial for distal obstruction, hydrosalpinx and adhesions. HSG had a high specificity for proximal obstruction, but a low sensitivity. Distal obstruction, absence of hydrosalpinx and adhesions had a poor accuracy. The likelihood ratio for the presence of hydrosalpinx was high. In conclusion, proximal tubal obstruction detected on HSG changes the pre-test probability of proximal tubal obstruction from 16 to 50%. Proximal tubal patency detected on HSG changes the pre-test probability of proximal tubal patency from 16 to 9%. It is unlikely that a lack of reproducibility of the interpretation of proximal tubal patency is responsible for the low sensitivity; alternative explanations are artefacts occurring while performing HSG or an imperfect reference strategy diagnostic laparoscopy. HSG is of limited use in diagnosing distal tubal obstruction and hydrosalpinx, and has no value in the detection of peritubal adhesions.

Fallopian Tube Diseases↗
PubMed1987

Salpingoscopy versus hysterosalpingography in hydrosalpinges.

A technique of translaparoscopic salpingoscopy is utilized to evaluate the ampullary segment of the Fallopian tube in patients suffering from infertility. Comparison of this technique with hysterosalpingography in a series of 32 patients with hydrosalpinges demonstrates its superiority in the evaluation of the tubal mucosa. This new diagnostic approach allows a more accurate selection of patients for either microsurgical repair, in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT).

Endoscopy↗
PubMed1990

Chlamydia trachomatis, tubal disease and the incidence of symptomatic and asymptomatic infection following hysterosalpingography.

The risk of causing or reactivating pelvic infection by hysterosalpingography (HSG) was assessed in 118 infertile women. Serological evidence of Chlamydia trachomatis infection was sought before, and 10 days and 4 weeks after HSG, using the single-antigen whole-inclusion immunofluorescence (WIF) test for species-specific antibody and the complement fixation test (CFT) for group antibody. Chlamydia antigen was detected using an ELISA. There was a close correlation between the finding of occlusive tubal damage and serum antibodies to C.trachomatis detected by both tests (P less than 0.001). Of 60 patients with WIF antibody titres greater than or equal to 1/64, 65% had evident tubal damage compared with only 16% of patients without a raised titre. Clinically suspected sepsis after HSG occurred in 4% of cases both with and without antibodies to C.trachomatis but only in those with tubal damage (10%). There was no serological evidence of C.trachomatis involvement in symptomatic or asymptomatic patients and anaerobic pathogens were isolated more commonly than C.trachomatis in those symptomatic cases. Isolation of C.trachomatis in two cases from the endocervix and also from the endometrium in one of these only after HSG was compatible with reactivation but not reinfection. Mycobacterium tuberculosis was isolated in two out of three cases with unsuspected tubal disease without antibodies to C.trachomatis. The risk of infection from HSG appears to be confined to patients with existing tubal damage, and in those unexpected cases without serological evidence of previous chlamydial infection, tuberculosis seems to be a likely cause.

Chlamydia Infections↗
PubMed1995

Safety and pharmacokinetics of iotrolan in hysterosalpingography. Retention and irritability compared with Lipiodol.

RATIONALE AND OBJECTIVES: The authors compared the safety and pharmacokinetics of Iotrolan (water-soluble) in hysterosalpingography (HSG) with those of Lipiodol (oil-soluble). METHODS: Iotrolan and Lipiodol were administered intraperitoneally at doses of 100 mg iodine/kg to female rabbits. Retention in the body was investigated by x-ray imaging, plasma kinetics, and urinary and fecal excretion. Irritability in the abdomen was investigated by histologic examination. RESULTS: Iotrolan was entirely excreted into the urine within 2 days after administration. Conversely, Lipiodol was excreted into the urine, had a half-life of 50 days, and was retained for more than 21 days in the abdomen. Iotrolan induced no inflammatory reaction in the abdomen, whereas Lipiodol induced a marked abdominal inflammatory reaction, including granuloma formation. Iotrolan had no effect on iodine concentration in the thyroid; Lipiodol increased iodine concentration significantly. CONCLUSIONS: Iotrolan, which is a water-soluble and nonionic dimeric contrast medium, has potential greater safety for use in HSG than Lipiodol.

Abdomen↗
PubMed1978

Tubal patency: hysterosalpingography compared with laparoscopy.

Laparoscopy was done about three months after hysterosalpingography (HSG) in 121 patients complaining of infertility. Normal patency was found with both technics in 71 patients (58.6%). In 23 of the 97 patients with a normal HSG, however, peritubal or tubal disease was observed at the time of laparoscopy (false-negative results, 19%). Twenty-four tubal obstructions (19.8%) were detected by HSG (16 distal and eight proximal) but five distal and four proximal obstructions were not confirmed by laparoscopy (false-positive results, 7.4%). In addition, laparoscopic evaluation demonstrated endometriosis in 31 cases, polycystic ovaries in six, and uterine fibroids in five.

Adnexal Diseases↗
PubMed2004

The use of intrauterine lidocaine to minimize pain during hysterosalpingography: a randomized trial.

OBJECTIVE: A hysterosalpingogram is an integral part of the evaluation of infertility but is often painful. Intrauterine anesthesia may help to alleviate the discomfort associated with this procedure. METHODS: We conducted a randomized, double-blinded, placebo-controlled trial of intrauterine lidocaine in women undergoing hysterosalpingography (HSG). All women were instructed to take a nonsteroidal analgesic before the hysterosalpingogram. Patients received 3 mL of buffered 2% lidocaine solution or 0.9% normal saline instilled into the uterus before HSG. The primary outcome was the degree of pain experienced documented via 10-cm visual analogue pain scales. Systematic assessments of discomfort were also collected by the attending physician, radiology technician, and radiology physician. RESULTS: Sixty-four patients were randomly assigned to placebo and 63 women were randomly assigned to the lidocaine group. There were no differences in mean age, race, parity, or history of dysmenorrhea or chronic pelvic pain. There were no differences in the pain scores at baseline, during, or after the study procedure between the 2 groups. Peak pain scale scores associated with the procedure were 5.3 +/- 0.4 in both the placebo and study groups. In addition, assessments of patient discomfort revealed no significant differences between the 2 groups. CONCLUSION: We found no difference in pain between the intrauterine-lidocaine and placebo groups. Intrauterine lidocaine does not appear to be effective in decreasing pain in women undergoing HSG. LEVEL OF EVIDENCE: I

Adult↗
PubMed2004

Pulmonary and cerebral oil embolism after hysterosalpingography with oil soluble contrast medium.

Pulmonary oil embolism (POE) is an extremely rare complication of hysterosalpingography (HSG). A case report of a 29-year-old woman who developed confusion and respiratory distress 12 h after HSG is presented. Intravasation of the contrast material was obvious on the HSG. High-resolution CT revealed ground-glass pattern predominantly in the lower lobes. The clinical picture and radiological findings improved on the tenth hospital day. It is believed that this is the first report of high-resolution CT findings in a case complicating HSG.

Adult↗
PubMed1976

Oviduct response to glucagon during hysterosalpingography.

Nine patients without evidence of tubal patency at routine hysterosalpingography were given glucagon. Five of the 9 responded with tubal dilation and spill. Three of the 4 who did not respond had a positive history and clinical examination for pelvic inflammatory disease. Data regarding side effects in the 9 patients studied are presented.

Fallopian Tubes↗
PubMed1978

Radiation dose in hysterosalpingography: modern 100mm fluorography vs. full-scale radiography.

Radiation doses of modern 100mm fluorography and full-scale radiography were compared experimentally and applied to hysterosalpingography. It was determined that 100mm fluorography reduced the doses by 28-29% per exposure and 37-47% per examination compared with full-scale radiography performed with fast tungstate screens in identical conditions (70-80 kV, 400 mA). The dose during one minute of videofluoroscopy was equivalent to the doses produced by one exposure in full-scale filming and three to four exposures in 100mm filming. Although electronic magnification in 100mm fluorography increases the doses by two or threefold, these are still less than the doses in full-scale radiography.

Female↗
PubMed1979

Hysterosalpingography with Amipaque.

The authors report their initial experience with Amipaque (metrizamide) in hysterosalpingography. Amipaque was compared to Isopaque Cerebral in 37 patients, using a double-blind design. Excellent radiographs were obtained with both agents. No statistically significant difference in discomfort and pain was found up to 24 hours after the procedure. However, the aftereffects indicate that Amipaque might be less irritating to the pelvic peritoneal cavity.

Adult↗
PubMed1979

Hysterosalpingography using a Foley catheter.

The authors describe a simple method of hysterosalpingography using a Foley catheter to inject contrast media. The technique allows the patient to assume a more comfortable position during the study. The radiologist can perform the examination without the need of a second physician to assist during spot filming and with no chance of metal artifacts obscuring anatomy.

Catheterization↗
PubMed1988

The current state of hysterosalpingography.

The authors present an overview of the current status of hysterosalpingography, discussing the advantages and disadvantages of various cannulas, contrast media, and methods of contrast medium introduction. Thirty-two figures illustrate a variety of abnormal findings including among others: intravasation of contrast medium, salpingitis isthmica nodosa, manifestations of pelvic inflammatory disease, the effects of DES exposure, Ascherman's syndrome, adenomyosis, carcinoma, polyps, myomata and developmental uterine abnormalities.

Fallopian Tube Diseases↗
PubMed1980

Prone hysterosalpingography.

The authors describe the usefulness of prone positioning during hysterosalpingography in the evaluation of nonvisualized fallopian tubes in infertility.

Female↗
PubMed1981

Angiodilator technique for hysterosalpingography in cervical os stenosis.

Obstruction of the endocervical canal of the uterus, frequently encountered after cauterization or cone biopsy, may result from a variety of benign and malignant diseases. Severe stenosis of the cervical os has made hysterosalpingography difficult. In ten patients, progressive dilatation with small vascular dilators was successful.

Adult↗
PubMed1984

Catheter hysterosalpingography.

The authors describe a 5-F catheter which is simpler to use than the standard vacuum cannula when performing hysterosalpingography.

Catheterization↗