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VOLUME 1 , ISSUE 2 ( May-August, 2008 ) > List of Articles

RESEARCH ARTICLE

Hysterosalpingography, Laparoscopy or Both in the Diagnosis of Tubal Disease in Infertility

Gokhan Goynumer, Gamze Yetim, Oznur Gokcen, Isin Karaaslan, Lale Wetherilt, Birol Durukan

Citation Information : Goynumer G, Yetim G, Gokcen O, Karaaslan I, Wetherilt L, Durukan B. Hysterosalpingography, Laparoscopy or Both in the Diagnosis of Tubal Disease in Infertility. World J Lap Surg 2008; 1 (2):23-26.

DOI: 10.5005/jp-journals-10007-1054

Published Online: 01-08-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objectives

To evaluate and compare the diagnostic value of hysterosalpingography (HSG) with laparoscopy in the assessment of fallopian tube patency in infertile women.

Design

A comparative prospective cross-sectional study.

Setting

Department of Obstetrics and Gynaecology in Goztepe Education and Research Hospital, Istanbul, Turkey.

Materials and Method

Laparoscopy was performed in 100 infertile patients with either unexplained infertility or tubal factors indicated by hysterosalpingography. Regarding laparoscopy as the reference standard, tubal patency findings in histerosalpingography were compared with laparoscopic findings.

Results

The sensitivity, specificity, positive predictive value, negative predictive value of HSG in detecting tubal patency were 0.80, 0.75, 0.91 (95 % CI 0.82-0.96), and 0.55 (95 % CI 0.38-0.70), respectively. The false-negative and false-positive rates of HSG in detecting tubal patency were 15 % and 6 %, respectively. Adnexial adhesions, ovarian cysts and pelvic endometriosis were detected in 27% of cases with normal HSG's. Of the twelve cases of bilaterally occluded tubes detected by HSG, only 3 (25%) were confirmed to have bilateral occlusion during laparoscopy.

Conclusion

Because HSG has a limited value for accurately identifying tubal patency, laparoscopy is necessary to rule out the existence of peritubal adhesions and mild and moderate endometriosis.


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