Hysterosalpingo-Contrast Sonography Compared with Hysterosalpingography and Laparoscopic Dye Pertubation to Evaluate Tubal Patency

Caterina Exacoustos, C. Exacoustós, Errico Zupi, C. Carusotti, Claudia Carusotti, Carusotti C, G Lanzi, Lanzi G, Giulio Lanzi, Marconi D, Daniela Marconi, Domenico Arduini, Arduini D
The Journal of the American Association of Gynecologic Laparoscopists · 2003 · vol. 10(3) , pp. 367–372 · doi:10.1016/s1074-3804(05)60264-2 · PMID:14567814 · W2167264236
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Hysterosalpingo-contrast sonography (HyCoSy) demonstrated high concordance with hysterosalpingography and laparoscopic dye pertubation in evaluating tubal patency and uterine cavity status.

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Abstract

Study objectiveTo evaluate the advantages and accuracy of hysterosalpingo-contrast sonography (HyCoSy) in assessing tubal patency compared with hysterosalpingogram (HSG) and laparoscopic dye pertubation.DesignProspective study (Canadian Task Force classification II-2).SettingObstetrics and Gynecology Department, University of Rome Tor Vergata.PatientsTwenty-three women with at least 1 year of infertility, and 15 women with a history of chronic pelvic pain, suspected endometriosis, or pelvic inflammatory disease (PID), or with sonographic markers of adhesions.InterventionsHyCoSy, HSG, and laparoscopic dye pertubation.Measurements and main resultsAll patients underwent HyCoSy during the proliferative phase using air with saline as contrast medium, and HSG within 1 month of HyCoSy. Laparoscopy and dye pertubation were performed only in women with chronic pelvic pain, suspected endometriosis, PID, and sonographic markers of adhesions. In women undergoing all three procedures, HSG and HyCoSy had the same high concordance as laparoscopy, 86.7% and 86.7%, respectively. Three women in the infertility group became pregnant immediately after HyCoSy and dropped out of the study. In one woman, HyCoSy could not be performed because of cervical stenosis. Considering the total number of tubes (67), concordance between HyCoSy and HSG was 89.6%.ConclusionTransvaginal HyCoSy using a combination of air and saline appears to be an inexpensive, fast, and well-tolerated method of determining tubal patency. One of the most important advantages of this technique is, in our opinion, the possibility of obtaining information on tubal status and the uterine cavity at the same time as conventional ultrasound scan is performed.

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MeSH descriptors

Fallopian Tube Diseases Infertility, Female Air Contrast Media Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tube Patency Tests Fallopian Tube Patency Tests Female Humans Hysterosalpingography Infertility, Female Laparoscopy Methylene Blue Predictive Value of Tests Prospective Studies Sensitivity and Specificity Sodium Chloride Ultrasonography

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