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PubMed1986

Comparative trial of tubal insufflation, hysterosalpingography, and laparoscopy with dye hydrotubation for assessment of tubal patency. World Health Organization.

A World Health Organization-sponsored multicentered trial comparing the efficacy of gaseous tubal insufflation with hysterosalpingography (HSG) and/or laparoscopy plus dye hydrotubation in the assessment of tubal patency was undertaken. Three hundred ninety-three women in eight centers were involved (365 insufflations, 289 HSG, 189 laparoscopy). Patency was proven positive in 56% of insufflation, 45% of salpingography, and 52% of laparoscopy cases. Laparoscopy showed some women to have fibroids and a number of others to have ovarian abnormalities, endometriosis, pelvic adhesions, and/or congenital uterine malformation. Comparison of insufflation and HSG showed a false-positive rate of 42% and false-negative rate 24% in 363 cases. The false-positive rate of insufflation versus laparoscopy was 35% and the false-negative rate 38% of 180 cases. Only 55% of 125 women undergoing both HSG and laparoscopy had similar findings. The results suggest that gaseous tubal insufflation should not be employed as a method of investigating tubal patency. Diagnostic reliability of HSG is poor, but it is useful as a primary screening procedure, particularly when complimented with laparoscopy plus dye hydrotubation, which is the optimum method not only for assessing tubal patency but for discovering other hitherto unsuspected disease.

Clinical Trials as Topic↗
PubMedDate not supplied

Complementary use of hysterosalpingography, hysteroscopy and laparoscopy in 100 infertile patients: results and comparison of their diagnostic accuracy.

While there is no disputing the invaluable role of laparoscopy in the study of the infertile woman, the function of hysterosalpingography (HSG) and hysteroscopy is still left open to debate. Our research concerns 100 infertile women undergoing HSG, hysteroscopy and laparoscopy; the aim of the study was to check the diagnostic accuracy of the three tests. The sensitivity and specificity of HSG vs hysteroscopy were 74.2% and 91.3% respectively. The sensitivity and specificity of HSG vs laparoscopy were 64.5% and 63.3% as regards tubal patency and 6.9% and 92.8% in the diagnosis of tubal phimosis and pelvic pathology. Despite the limits HSG revealed, our results show that a correct study of the infertile woman can only be accomplished by a combination of all three tests; we therefore recommend a combined approach using all three procedures in all infertile patients.

Adult↗
PubMedDate not supplied

Simple and practical technique for hysterosalpingography: results obtained in 564 cases.

About 5 years ago, we proposed a new technique for hysterosalpingography in order to make it simpler for the gynecologist and the radiologist and more readily acceptable for the patients. In our opinion, the technique is simple and practical; we have performed ISG's with it and have succeeded in 555 cases, that is, 98.4%; in 9 cases, 1.6%, we did not succeed. In 5 of these 9 cases, the failure was due to an error in the application of the technique. This technique, however, must not be used in patients with suspected didelphic uterus or septum or with an unsuitable portio. In none of the patients was the technique followed by complications.

Female↗
PubMed1986

[Hysterosalpingography with simultaneous intrauterine pressure measurement. A contribution to invasive sterility diagnosis].

There will be demonstrated a method in order to contrast the cavum uteri and the uterine tubes by means of a x-ray TV amplifier in combination with simultaneous intrauterine pressure monitoring. We could demonstrate that measuring the intrauterine pressure during continuous flow of radio-opaque material at hysterosalpingography results in additional informations about tubal patency.

Constriction, Pathologic↗
PubMed1986

[Ovarian radiation dosage during hysterosalpingography].

Doses delivered to ovaries during a standardized hysterosalpingography is determined in 30 patients with LiF dosimeters placed on the anterior and the posterior wall of the lower abdomen. It varies between 0.1 and 0.6 rad and is essentially dependent on the thickness of traversed tissues. This work is based on rare-earth screens experience.

Female↗
PubMedDate not supplied

Hysterosalpingography: value in estimating tubal function, and risk of infectious complications.

A prospective study of 80 patients referred for hysterosalpingography (HSG). In 74 patients HSG was performed as part of an infertility investigation. Samples taken from the cervix were cultured for N. gonorrhoeae, Chl. trachomatis and M. hominis. Serum specimens were examined for antibodies against Chl. trachomatis and M. hominis. Two of our patients (2,5%) developed clinical signs of pelvic inflammatory disease following the procedure. Both had negative cultures for pathogenic microbes. The value of pre-HSG microbial culturing seemed negligible. Most patients had antibodies against Chl. trachomatis and M. hominis. Occlusion in one or both tubes was seen in 22 patients while possible pelvic adhesions were found in 15. It is concluded that HSG seems to have a relatively high risk of infectious complications, and we propose to do laparoscopy with chromopertubation as the primary step for evaluation of tubal function in infertile women.

Cervix Uteri↗
PubMed1985

[Peritubal adhesions and hysterosalpingography].

Hysterosalpingography cannot directly show pelvic adhesions due to pelviperitonitis, salpingitis, perimetritis or parametritis. Nevertheless this method is able to evidence an eventual tubal involvement by adhesive tissue. Located pools of contrast medium around the tubae is a well known radiological sign, but not the only nor the most frequently one observed. If the adhesions include the proximal end of the tubae, the contrast pooling may be absent. This paper analyzes, in controlled series of patients with pelvic adhesions, all the hysterosalpingographic signs which can indicate an adhesive tubal involvement.

Adult↗
PubMed1985

[Hysterosalpingography with the Foley catheter].

Five-hundred hysterosalpingographies with Foley-catheter were investigated and compared to that made with Schultze-instrument. The investigations were performed in both phases in cases of cyclic menstrual bleeding. The advantages of the method used are the followings: simple, atraumatic, painless. There was no flow-back of the contrast material, the shape of the internal genitals was visible in the proper position, moreover, the present method allowed an observation in the original state of the shape of the internal os and the cervical canal by a x-ray-amplifier. The method simplified the hydrotubations during and after plastic surgery on the fallopian tubes. The method can not be employed in the case of Asherman's syndrome, where the uterine cavity is significantly narrowed.

Catheterization↗
PubMed1984

Hysteroscopy versus hysterosalpingography in infertile patients.

The purpose of this study is to compare the results of Hysterosalpingography (HSG) and those of Hysteroscopy (H) in order to evaluate intrauterine morphology in a sample of 47 infertile patients. In the HSG sample having no intrauterine pathology, H showed up a pathological condition in 30% of the cases. Similarly, in the cases in which HSG showed pathologies, H gave normal results in 33.3%. Considering H to be a simple diagnostic method, which causes little trauma to the patient, and is more precise than HSG, the authors recommend the hysteroscopic approach, especially in cases of sterility of unknown origin.

Adult↗
PubMed1982

A comparison of hysterosalpingography and laparoscopy in the investigation of infertility.

From 1974-1980, 85 patients were investigated with both hysterosalpingography (HSG) and laparoscopy. Discordant diagnosis of adhesions made the largest group of disagreements. The causes of such and other discrepancies are discussed. The Authors conclude that laparoscopy is necessary to establish a conclusive assessment of the tubal factor and must be performed before HSG. The radiologic investigation still has its place to demonstrate lesions of endosalpinx before microsurgery.

Female↗
PubMed1984

Hysterosalpingography in the assessment of infertility in black patients.

A series of 200 consecutive hysterosalpingograms for the evaluation of infertility in Black women attending a clinic at the Hillbrow Hospital, Johannesburg, is reviewed. A fallopian tube abnormality was found in 81,8% of cases, terminal hydrosalpinx being present in 64,4%. A uterine abnormality was present in 25% of cases. In comparison with other series it appears that our incidence of tubal lesions, especially terminal hydrosalpinx, is the highest yet reported. A high correlation with laparoscopic findings (75%) is documented. In our infertility clinic hysterosalpingography is one of the most valuable tools in the initial evaluation of the infertile couple.

Adult↗
PubMed1980

[Laparoscopy and hysterosalpingography in sterility examination (author's transl)].

Hysterosalpingographic and laparoscopic findings were recorded from 90 patients and compared. They were identical in 71 per cent of all cases, but in some of the cases additional findings proved recordable from laparoscopy. The point is made by the authors that laparoscopy should in any case be preceded by hysterosalpingography, since the latter is a comparatively uninvolved method which even may have therapeutic effects. Laparoscopy is indicated particularly in pathological cases or in cases of uncertain diagnosis or prior to surgery for salpingoplasty. This is the only diagnostic method by which accurate assessment is possible of the organs in the minor pelvis and of tubal function. Today, laparoscopy may be considered a safe no-risk procedure, if all necessary conditions are provided, but adequate equipment actually is available only in larger institutions at present.

Adolescent↗
PubMed1981

Comparative study of hysterosalpingography and laparoscopy in infertile patients.

The diagnostic accuracy of hysterosalpingography (HSG) and laparoscopy was investigated in 168 consecutive patients with infertility of at least 2 years' duration. There was agreement between the results of both methods in 57.7 per cent of the patients. Among 54 patients having normal HSG, 16 (29.6 per cent) exhibited abnormalities at laparoscopy. Among 114 patients with abnormal HSG, 28 (24.6 per cent) had entirely normal internal genitalia at laparoscopy. The greatest discrepancy between the HSG and laparoscopic diagnoses was found in peritubal adhesions. Intrauterine abnormalities were diagnosed by HSG in only 2.4 per cent of the patients. Complications of laparoscopy were few and none was serious. For a conclusive evaluation of the tubal factor in infertility, one must consider abandoning HSG entirely in favor of laparoscopy.

Adult↗
PubMed1983

[A major complication of hysterosalpingography].

The authors report in detail the observation of a patient who presented with urticaria and anaphylactic shock during hysterosalpingography. A review of the literature analyzing different accidents and incidents related to this examination, showed the rarity of such reactions. The authors insist, once more, on the necessity of always having the adequate material and drugs for early intensive treatment. These should be at hand whenever investigation with iodine contrast products are used, whatever the route of administration.

Adult↗
PubMed1984

[Pericaval intravasation of contrast media in the changed indication for hysterosalpingography].

Today the indication of hysterosalpingography is supplied via radiography in the diagnosis of female infertility patients. Hence, a different group of patients is now selected in contrast to the previous indications. The venous intravasation in uterine and adnexal vessels among infertility patients was observed in only 0.4% of our cases. The relationship between the changed indication, the technique of HSG, the changed permeability of the vessels after surgery, and the rare occurrence of intravasation is discussed.

Adult↗