Comparisons of Hysterosalpingography and Laparoscopy Results in the Diagnosis of Tubal Occlusion

Rafet Duraker, Berfu Demir, Berna Dilbaz, Ozgur Akkurt, Mehmet Özgür Akkurt, Müberra Koçak, Yasemin Taşçı, Ümit Göktolga
In: Journal of Turkish Society of Obstetric and Gynecology · 2011 · vol. 8(1) , pp. 40–43 · doi:10.5505/tjod.2011.89266 · W2170166661
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Hysterosalpingography showed high misdiagnosis rates for tubal occlusion compared to laparoscopy, with no significant difference in endometriosis incidence across tubal occlusion groups.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This retrospective study reviewed medical records of 139 women who underwent hysterosalpingography (HSG) followed by laparoscopy with chromopertubation to investigate concordance in diagnosing tubal occlusion. HSG confirmed by laparoscopy at a lower rate for unilateral occlusion (38.8%) than for bilateral occlusion (58.8%), with a significantly higher HSG misdiagnosis rate in unilateral cases than bilateral cases. Endometriosis was observed in 28.4% of women with patent tubes, 13.9% with unilateral tubal occlusion, and 22.7% with bilateral tubal occlusion, but differences across groups were not statistically significant. This paper is centrally about endometriosis—evaluating the incidence of endometriosis in relation to HSG-diagnosed tubal patency and occlusion and positioning laparoscopy with chromopertubation as a gold standard for detecting endometriosis.

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Abstract

SUMMARY Objective: The compliance rate between the hysterosalpingography (HSG) and laparoscopy (L/S) results in patients who diagnosed tubal occlusion on the HSG was investigated. Also, the incidence of endometriosis was evaluated in the study population. Material and methods: Medical records of 139 women who were underwent L/S for the investigation of the tubal occlusion were reviewed retrospectively. The concordance rate between the HSG and L/S was investigated. The incidence of endometriosis in patients with no tubal pathology was compared with patients with unilaterally and bilaterally tubal occlusion. Results: Mean age of the women was 31.8±5.7years, mean BMI was measured as 24.6±4.6 kg/m2, and gravida 0 (05), mean infertility period was 30.7±3.7 months. Tubal occlusion was confirmed after the L/S in 38.8% of the patients (n=38) who has unilaterally tubal occlusion on the HSG. However, 58.8% (n=20) of the patients who were diagnosed as bilaterally tubal occlusion on the HSG was confirmed with the L/S. The misdiagnosis rate of the HSG was significantly high in women with unilaterally tubal occlusions compared with bilaterally tubal occlusions [(respectively, 61.2%, 51.2%) (p:0.001)]. Endometriosis was observed in 28.4% of the patients who had patent tubes and in 13.9% of the patients in the unilaterally tubal occlusion group and and in 22.7% of the patients in the bilaterally tubal occlusion group. But the difference was not statistically significant when groups were compared according to the rate of endometriosis (p=0.24). Conclusion: HSG is the first step diagnostic test for the assessment of the fallopian tubes. Although L/S is more invasive technique than HSG, L/S with chromopertubation is the gold standard test for identifying periadnexal adhesive disease and endometriosis.
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Abstract

Objective: The compliance rate between the hysterosalpingography (HSG) and laparoscopy (L/S) results in patients who diagnosed tubal occlusion on the HSG was investigated. Also, the incidence of endometriosis was evaluated in the study population.

Material and methods

Medical records of 139 women who were underwent L/S for the investigation of the tubal occlusion were reviewed retrospectively. The concordance rate between the HSG and L/S was investigated. The incidence of endometriosis in patients with no tubal pathology was compared with patients with unilaterally and bilaterally tubal occlusion.

Results

Mean age of the women was 31.8±5.7years, mean BMI was measured as 24.6±4.6 kg/m2, and gravida 0 (0-5), mean infertility period was 30.7±3.7 months. Tubal occlusion was confirmed after the L/S in 38.8% of the patients (n=38) who has unilaterally tubal occlusion on the HSG. However, 58.8% (n=20) of the patients who were diagnosed as bilaterally tubal occlusion on the HSG was confirmed with the L/S. The misdiagnosis rate of the HSG was significantly high in women with unilaterally tubal occlusions compared with bilaterally tubal occlusions [(respectively, 61.2%, 51.2%) (p: 0.001)]. Endometriosis was observed in 28.4% of the patients who had patent tubes and in 13.9% of the patients in the unilaterally tubal occlusion group and and in 22.7% of the patients in the bilaterally tubal occlusion group. But the difference was not statistically significant when groups were compared according to the rate of endometriosis (p=0.24).

Conclusion

HSG is the first step diagnostic test for the assessment of the fallopian tubes. Although L/S is more invasive technique than HSG, L/S with chromopertubation is the gold standard test for identifying periadnexal adhesive disease and endometriosis.

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