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PubMed1996

Patient doses in hysterosalpingography.

The results of a survey of doses imparted on 41 patients undergoing hysterosalpingography is presented. Dosimetric evaluations were carried out by measuring both the dose-area product using a transmission ionization type chamber, and the entrance surface dose using thermoluminiscent dosimeters. As a result, a local reference dose value was obtained for this examination. Correlations between the dose-area product and the entrance surface dose data were analysed and compared in order to find the most appropriate dosimetric procedure. The median dose-area product obtained was 713 cGy cm2 (range 247 cGy cm2-1623 cGy cm2). Ovarian doses were also calculated, and a median value of 4.6 mGy was obtained for the whole examination. Effective doses were estimated with a median value of 3.1 mSv, and a range of 1.0 mSv-8.1 mSv.

Adult↗

PubMed1998

Patient dosimetry in hysterosalpingography: a comparative study.

Ovarian doses for 45 women undergoing hysterosalpingography (HSG) at our institution were calculated. Lithium borate thermoluminescent dosemeters were used to measure entrance surface doses in standard positions. The study compares the estimated dose received by 21 patients undergoing the procedure using an analogue fluoroscopic unit and standard film-screen radiography with that received by 24 patients who were imaged using a digital screening system with a C-arm. Our results show significant dose reduction is obtainable for patients undergoing HSG when a digital system is employed.

Adult↗

PubMed2006

Equivalent dose to organs and tissues in hysterosalpingography calculated with the FAX (Female Adult voXel) phantom.

Hysterosalpingography (HSG) is a radiological examination indicated for investigating infertility or uterine and tubal pathologies. Women who undergo HSG are relatively young, typically between 20 years and 40 years, and equivalent doses to the ovaries are usually reported to be around 4 mSv per examination. A review of studies on patient dosimetry in HSG revealed that almost all absorbed doses to organs and tissues had been calculated with conversion coefficients (CCs) based on hermaphrodite versions of MIRD5-type phantoms. The CCs applied had been taken from data sets for abdominal or pelvic examinations because CCs for HSG examination were not available. This study uses the FAX (Female Adult voXel) phantom in order to calculate equivalent doses to radiosensitive organs and tissues especially for exposure conditions used in HSG. The calculations were also performed for the MIRD5-type EVA phantom to demonstrate the influence of anatomical differences on organ equivalent dose. The results show organ and tissue equivalent doses as a function of the variations of the exposure conditions. At 4.56 mSv the ovarian equivalent dose calculated for the FAX phantom is about 21% greater than the average ovarian equivalent dose reported in the literature, which reflects the anatomical differences between the FAX and the MIRD5-type phantoms.

Adult↗

PubMed2006

Hysterosalpingography for assessing efficacy of Essure microinsert permanent birth control device.

OBJECTIVE: The Essure microinsert is a new U.S. Food and Drug Administration-approved method of birth control. The objective of this study is to report our initial experience using hysterosalpingography (HSG) to assess its efficacy for permanent tubal occlusion. CONCLUSION: The Essure microinsert produced tubal blockage in all patients. As this device may become more widely used, radiologists should be aware of the device's appearance and be able to assess device position and presence of tubal occlusion on HSG.

Adult↗

PubMed1982

Hysterosalpingography: comparison of Conray 60 and Sinografin.

Conray 60 and Sinografin were compared as contrast agents for hysterosalpingography in 40 consecutive patients in a double-blind protocol. Emphasis was centered on the incidence and severity of symptoms during and after the procedure. Of patients receiving Conray, 36% suffered moderate or severe discomfort compared with 78% of the patients receiving Sinografin, and 13% of patients receiving Conray complained of moderate delayed discomfort compared with 28% of those receiving Sinografin. Both agents produced excellent diagnostic studies. Conray was clearly superior to Sinografin in terms of patient comfort.

Diatrizoate↗

PubMed1989

The value of hysterosalpingography before reversal of sterilization procedures involving the fallopian tubes.

Knowledge of the length of the uterine end of the fallopian tube and the presence of tubal adhesions and fistulas is important when surgical reversal is undertaken in patients who have had tubal ligation. We retrospectively studied hysterosalpingograms in 127 such patients to determine their value in providing this information. The ligation was performed by using the Pomeroy technique in 57 patients. Sixty-one patients had bipolar electrocautery, six had Falope rings inserted, and three had Hulka clips applied. In all cases, the uterine ends of the tube were visualized to a point of obstruction. The sites of occlusion after Pomeroy ligation were midtubal (46%), cornual (16%), proximal ampullary (16%), proximal isthmic (14%), and intramural (8%). After the electrocautery procedure, the sites of occlusion were proximal isthmic (45%), intramural (20%), midtubal (19%), cornual (15%), and proximal ampullary (1%). When Falope rings and Hulka clips were used, the most frequent site of occlusion was midtubal (50%). Tubal adhesions, consistent with successful occlusion, were detected in 16 patients on the basis of a small confined area of extravasation of contrast material at the site of ligation. Tuboperitoneal fistulas, identified by the presence of contrast material spilled from the uterine end of the tube into the peritoneal cavity, were detected in five patients. Our results show that hysterosalpingography is a useful technique for determining the status of the uterine end of the fallopian tube after ligation when reversal of ligation is planned.

Female↗

PubMed2004

Diagnostic value of hysterosalpingography in the detection of intrauterine abnormalities: a comparison with hysteroscopy.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic accuracy of hysterosalpingography (HSG) in comparison with hysteroscopy in the detection of intrauterine abnormality in infertile patients. MATERIALS AND METHODS: Seventy-eight patients being investigated for infertility and undergoing HSG and hysteroscopy were studied retrospectively. Radiologic findings on HSG, including single or multiple filling defects and uterine wall irregularities, were evaluated and compared with hysteroscopic findings, which were considered the reference standard. RESULTS: HSG showed a sensitivity of 81.2% compared with that of hysteroscopy and a specificity of 80.4%, with a positive predictive value of 63.4% and a negative predictive value of 83.7%. HSG also had a false-negative rate of 90% and a false-positive rate of 21.8%. Overall agreement between the two procedures was 73%. CONCLUSION: HSG is still a useful screening test for the evaluation of the uterine cavity in the study of primary or secondary infertility. In addition, HSG provides information concerning the assessment of tubal morphology and patency. We believe that these two procedures are complementary in the evaluation of the uterine cavity.

Adult↗

PubMed1998

Diagnostic quality in hysterosalpingography. Comparison between iodixanol and iotrolan.

PURPOSE: To compare the diagnostic quality and adverse events of the water-soluble, non-ionic, iso-osmolar, dimeric contrast media iodixanol and iotrolan in hysterosalpingography (HSG). MATERIAL AND METHODS: One hundred and twenty patients participated in a double-blind randomized parallel-group phase-III study. Questionnaires and patient interviews were used. Diagnostic quality was assessed using a visual analogue scale and the quality in specific regions was rated using a categorical scale. RESULTS: Overall diagnostic quality was equal for the two groups. There was no statistically significant difference between the two groups in diagnostic quality in the specific regions of interest. No differences between the contrast media were found with regard to adverse events. CONCLUSION: Both contrast media provided images of high diagnostic quality in HSG.

Contrast Media↗

PubMedDate not supplied

Tubal abnormalities on hysterosalpingography in primary and secondary infertility.

BACKGROUND: Hysterosalpingography (HSG) is an imaging modality used in assessing the fallopian tubes of patients with infertility. There have been reports suggesting that tubal pathologies may be responsible for most cases of secondary infertility. OBJECTIVE: To evaluate the fallopian tube of women with infertility and to observe if there are significant differences in the tubal findings in primary and secondary infertility. METHODOLOGY: One hundred and twenty (120) patients attending the outpatient fertility clinics in University of Ilorin Teaching Hospital, (UITH) Nigeria were studied; Twenty-four (20%) presented with primary infertility and Ninety-six (80%) with secondary infertility. All the patients had HSG. RESULTS: A total of 48(40%) patients out of the 120 studied had a tubal pathology, out of which 43 (44.8%) had secondary infertility and 5(20.8%) had primary infertility. Tubal pathology was found to be significantly associated with secondary infertility than primary infertility (P< 0.05, Odds ratio = 3, CI = 95%).

Adult↗

PubMed2000

[The correlation between intrauterine filling defects during hysterosalpingography and endometriosis at laparoscopy].

The association of intrauterine filling defects on hysterosalpingogram with endometriosis was evaluated. One hundred twenty patients were prospectively investigated with both methods, hysterosalpingography (HSG) and laparoscopy (LSC), for period of two years. HSG was performed on days 7-10 with water-soluble contrast medium. The presence of endometriosis was proved laparoscopically and scored according to the American Fertility Society classification. Forty-one women had endometriosis at LSC. In 25 of all 30 women with filling defects on hysterosalpingogram endometriosis was found. The presence of intrauterine filling defects on HSG is significantly associated with the presence of pelvic or peritoneal endometriosis.

Adnexal Diseases↗

PubMedDate not supplied

Assessment of the value of preliminary films at hysterosalpingography.

The usefulness of preliminary films in the Hysterosalpingographic evaluation of infertility is studied using the Hysterosalpingogram of 200 patients, comprising 83 primary and 117 secondary infertility cases. There were overall 12 (6.0%) demonstrable lesions, 4 (4.8%) in the preliminary films of primary infertility patients and 8 (6.8%) in that of secondary infertility patients. Osseous lesions were found in 4 (2.0%) patients comprising 2 (2.4%) patients with primary infertility and 2 (1.7%) patients with secondary infertility. Non-osseous lesions were found in 8 (4.0%) patients, comprising 2 (2.4%) patients with primary infertility and 6 (5.1%) patients with secondary infertility. The overall numbers of pathological lesions, 12 (6.0%) discerned through preliminary film are too few to justify its continued practice. This and other relevant factors that would prohibit the use of preliminary films at Hysterosalpingography are discussed.

Costs and Cost Analysis↗

PubMedDate not supplied

[Hysterosonosalpingography and hysterosalpingography in the diagnosis of tubal patency in infertility patients].

OBJECTIVES: To compare the hysterosonosalpingography(HSS) to the hysterosalpingography(HSG) in the evaluation of the tubal factor in infertility patients. MATERIAL AND METHODS: A transversal study with 30 patients in infertility investigation, with age minor than 38 years was performed. The patients were submitted to HSS, HSG and laparoscopy (LPC) in the first cycle menstrual phase. The evaluation of tubal patency of HSS and HSG, with LPC like gold-standard was compared. It was calculated the negative predictive value (PV-) of the exams. The HSS used Ecovist like contrast agent, the HSG used water soluble contrast media and the LPC used tubal insufflation with methylene blue. It was considered significative a p< 0.05 RESULTS: The final sample was of 26 patients (4 leave the investigation). The mean age was of 30,6 years. The HSS showed tubal patency in at least one of the tubes in 24 patients (92,3%). The HSG showed tubal patency in one of the tubes in 25 patients (96,2%), and the LPC in 25 patients (96,2%). The PV- of the HSS was of 92% and the PV- of HSG was of 100%. The differences were not statistically significant (p=0.996, Yates test). CONCLUSIONS: The HSS is an alternative method in the evaluation of tubal patency in infertility patients.

Adult↗

PubMedDate not supplied

[Diagnostic value of hysterosalpingography in examination of Fallopian tubes in infertile women].

UNLABELLED: Hysterosalpingography (HSG) is a radiographic examination of endocervical canals, uterine cavity and Fallopian tube with the use of a radiographic contrast medium [1]. This method is an integral part of gynaecological examination and its value has not been underestimated in the modern gynaecological practice. GOAL OF THE STUDY: The goal of the study was to evaluate the reliability of HSG in the diagnosis of Fallopian tube and to compare the obtained results with laparoscopic findings. METHODS: The study included 140 infertile women. HSG was performed in the first half of the cycle, usually on the ninth day, without anaesthesia. The instruments after Schultze were used; 15 mL of Telebrix-contrast was used. Three radiograms were done. Laparoscopic examination was carried out in general endotracheal anaesthesia. A Storz laparoscope was used. CO2 was used for artificial pneumoperitoneum and indigolipstick for tube passage. The obtained findings were elaborated statistically. Descriptive and analytic models were used. p < 0.05 and p < 0.01 were considered as a risk factor of statistical significance. RESULTS: An approximate time interval between the two procedures was 5.18 months. Normal findings of HSG examination were noted in 53 women (37.9%); tube occlusion in 67 women (47.9%), and peritubal adhesion with tubal passage in 20 (14.3%) patients. A normal finding was found in 56 women (40.0%), tubal occlusion in 64 women (45.7%), and peritubal adhesion with tubal passage in 20 (14.3%) patients. HSG and laparoscopic findings regarding normal tubes were in agreement in 32 women (22.9%), tubal occlusion in 35 women (25.0%) and peritabal adhesion with tubal passage in 5 (3.6%) patients. The best sensitivity of HSG was observed in detection of proximal tubal occlusion (78%), and the smallest in occlusion with the accompanying adhesion (2%). The best specificity of HSG was noted in the diagnosis of combined occlusions (96%) and the smallest in tubal passage with peritubal adhesion (25%). There were 15% of false negative findings and 17.1% of false positive findings. DISCUSSION: The time interval from one to the other procedure can be considered as an important factor in laparoscopic confirmation or negative HSG findings. With the continuation of the time interval the conditions are made for the aggravation of old and occurrence of new pathological processes in genital internal female organs. The possible causes of differential diagnosis of tubal occlusion between HSG and laparoscopic examination might be: 1) unequal anaesthesia during HSG and laparoscopic examination; 2) different properties of contrast media; 3) anatomic variations in the width of lumen tubes; 4) erroneous interpretation of the results. The sensitivity of HSG in this study was different in various types of tubal passage. In other studies the sensitivity of HSG was from 65% [10] to 96%[7]. The high specificity was found during detection of combined tubal occlusion (96%). The results of other authors were similar [7, 10]. This is a good contribution to the statement that HSG is a useful test of tubal obstruction. A rather high percent of false positive results of HSG was established in this study. The possible reasons might be tubal spasm and endometrial polyp in the area of the uterine opening of the tubes. CONCLUSION: On the basis of the obtained results, the following conclusions can be drawn: 1) HSG is a simple method for examination of female sterility; 2) HSG and laparoscopy are the complementary methods in the examination of tubal sterility; 3) HSG is inferior in relation to laparoscopy in the examination of peritubal adhesion.

Constriction, Pathologic↗

PubMedDate not supplied

[Ultrasound hysterosalpingography with levovist in the diagnosis of tubaric patency].

UNLABELLED: PURPOSE AIM: To asses the diagnostic value of hysterosalpingo-contrast sonography (HyCoSy) with Levovist(R) as alternative to conventional hysterosalpingography (HSG) in the study of infertility. MATERIAL AND METHODS: From September 1988 to March 2000 we evaluated 120 patients with a history of infertility. Thirty patients underwent both HyCoSy and HSG. HyCoSy was performed in the pre-ovulatory phase of mestrual cycle. The tecnique was the same for both examinations. After administering 15 ml contrast medium, we visualized the endometrial cavity, the flow of the contrast medium along the fallopian tubes and its passage into the peritoneum. RESULTS: In all cases Color-Power Doppler allowed visualization of the uterine cavity and of the spilling of the contrast medium into the peritoneum, yielding information on tube patency that was comparable to that obtained by conventional HSG. In 28 cases (93%) we obtained optimal visualization of the contrast medium at the level of both the endometrial cavity and the fallopian tubes. HyCoSy proved to be superior to conventional HSG in evaluating adjacent myometrial structures, adnexa and degree of follicular maturation, equal to HSG in visualizing the passage of the contrast medium into the peritoneum but inferior to HSG in imaging the fallopian tubes owing to their tortuosity. DISCUSSION AND CONCLUSIONS: The absence of ionising radiation makes HyCoSy a possible first choice examination in the evaluation of fallopian tube pathology. Conventional HSG should be kept for doubtful cases or for surgical procedures to correct mono- or bilateral obstruction.

Adult↗

PubMed2001

[The usefulness of hysteroscopy and hysterosalpingography in diagnosis of tubal infertility].

OBJECTIVES: To estimate the usefulness of hysteroscopy (HSC) and hysterosalpingography (HSG) examination on a retrospective study. DESIGN: Canulisation and morphology of ovarian tube detected during HSG and reactivity of uterine tubal ostia observed in HSC were compared. MATERIAL AND METHODS: The results of HSG and HSC examination performed on 125 young infertile women whom the tubal uterine factor of infertility was suspected were analyzed 250 ovarian tubes, after previous selection were taken into consideration. The analysis had a retrospective character. RESULTS: The analyzed group of women were divided into 3 group which differed from each other in reactivate of uterine ostia of the ovarian tubes. The first group first with correct reactivity of tubal ostia was the largest. The authors observed canulisation, which was the best in the first group and morphologic changes in the internal structure of the ovarian tubes. The highest percentage of these changes were observed in group three with unreactive uterine ostia. CONCLUSIONS: The HSG and HSC examination are supplementary examinations. The use of both methods together increases their diagnostic value and gives a more correct estimation of tubal status.

Adult↗

PubMedDate not supplied

[Diagnostic value of hysterosalpingography in examination of fallopian tubes in infertile women].

UNLABELLED: Hysterosalpingography (HSG) is a radiographic examination of endocervical canals, uterine cavity and Fallopian tube with the use of a radiographic contrast medium [1]. This method is an integral part of gynaecological examination and its value has not been underestimated in the modern gynaecological practice. GOAL OF THE STUDY: The goal of the study was to evaluate the reliability of HSG in the diagnosis of Fallopian tube and to compare the obtained results with laparoscopic findings. METHODS: The study included 140 infertile women. HSG was performed in the first half of the cycle, usually on the ninth day, without anaesthesia. The instruments after Schultze were used; 15 mL of Telebrix-contrast was used. Three radiograms were done. Laparoscopic examination was carried out in general endotracheal anaesthesia. A Storz laparoscope was used. CO2 was used for artificial pneumoperitoneum and indigolipstick for tube passage. The obtained findings were elaborated statistically. Descriptive and analytic models were used. p < 0.05 and p < 0.01 were considered as a risk factor of statistical significance. RESULTS: An approximate time interval between the two procedures was 5.18 months. Normal findings of HSG examination were noted in 53 women (37.9%); tube occlusion in 67 women (47.9%), and peritubal adhesion with tubal passage in 20 (14.3%) patients. A normal finding was found in 56 women (40.0%), tubal occlusion in 64 women (45.7%), and peritubal adhesion with tubal passage in 20 (14.3%) patients. HSG and laparoscopic findings regarding normal tubes were in agreement in 32 women (22.9%), tubal occlusion in 35 women (25.0%) and peritubal adhesion with tubal passage in 5 (3.6%) patients. The best sensitivity of HSG was observed in detection of proximal tubal occlusion (78%), and the smallest in occlusion with the accompanying adhesion (2%). The best specificity of HSG was noted in the diagnosis of combined occlusions (96%), and the smallest in tubal passage with peritubal adhesion (25%). There were 15% of false negative findings and 17.1% of false positive findings. DISCUSSION: The time interval from one to the other procedure can be considered as an important factor in laparoscopic confirmation or negative HSG findings. With the continuation of the same time interval the conditions are made for the aggravation of old and occurrence of new pathological processes in genital internal female organs. The possible causes of differential diagnosis of tubal occlusion between HSG and laparoscopic examination might be: 1) unequal anaesthesia during HSG and laparoscopic examination; 2) different properties of contrast media; 3) anatomic variations in the width of lumen tubes; 4) erroneous interpretation of the results. The sensitivity of HSG in this study was different in various types of tubal passage. In other studies the sensitivity of HSG was from 65% [10] to 96% [7]. The high specificity was found during detection of combined tubal occlusion (96%). The results of other authors were similar [7, 10]. This is a good contribution to the statement that HSG is a useful test of tubal obstruction. A rather high percent of false positive results of HSG was established in this study. The possible reasons might be tubal spasm and endometrial polyp in the area of the uterine opening of the tubes. CONCLUSION: On the basis of the obtained results, the following conclusions can be drawn: 1) HSG is a simple method for examination of female sterility; 2) HSG and laparoscopy are the complementary methods in the examination of tubal sterility; 3) HSG is inferior in relation to laparoscopy in the examination of peritubal adhesion.

Constriction, Pathologic↗

PubMed2002

[Features of hysterosalpingography performed in Burkina Faso].

PURPOSE: The goal of this study was to describe the distinctive hysterosalpingographic features of women with infertility in Burkina Faso. MATERIALS AND METHODS: We performed a retrospective study of 1019 women who were referred for infertility between January 1996 to June 1997 at the National Hospital Centre of Ouagadougou. Clinical and radiological features were reviewed and statistical data analysed on the software EPI Info 5.0. RESULTS: The mean age of the patients was 28+/-0,3 years. Primary infertility was found in 34.4% and secondary infertility in 65.6%. Abnormalities on plain film were present in 6.9% of the cases. Hysterosalpingography was abnormal in 62.1% of the cases. Tubal abnormalities were found in 62% and uterine lesions in 38.3%. The main hysterosalpingographic abnormalities were tubal obstructions, hydrosalpinx, uterine fibromas, and trauma sequelae in 25,9%, 25,3%, 16,5% and 10% of cases respectively. Seventy one percent of tubal and uterine lesions represent outcomes of chronic infections and underground abortions. CONCLUSION: In Burkina Faso, hysterosalpingographic abnormalities are characterized by the predominance of infectious and traumatic sequelae. Such a frequency could be reduced by active politics against underground abortion and information about genital infections.

Adult↗

PubMed1978

Comparative evaluation of laparoscopy and hysterosalpingography in infertile patients.

A comparative study of hysterosalpingography (HSG) and laparoscopy in the investigation of infertility is presented. From 1973-1977, 352 cases were investigated with both HSG and laparoscopy. In 57.67% of the cases there was complete agreement between HSG and laparoscopy. The study included 168 cases of unexplained infertility and 184 cases with abnormal hysterosalpingographic findings. Pelvic adhesions were demonstrated in 151 cases by laparoscopy as compared to 76 cases in which its presence was only suspected by HSG. Laparoscopy revealed a 57.14% of associated pelvic pathology in cases of unexplained fertility. The present study concludes that laparoscopy as compared to HSG is not only more informative, but also more accurate and conclusive.

Adnexal Diseases↗