Accuracy of Assessment of Tubal Patency With Selective Pertubation at Office Hysteroscopy Compared With Laparoscopy in Infertile Women

Török, Péter; Major, Tamás

doi:10.1016/j.jmig.2012.03.016

Cited by 35 publications

(30 citation statements)

References 8 publications

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“…Intravasation or false passage due to unintentional perforation may occur because tubal cannulation occurs blindly without laparoscopic or sonographic surveillance. 16 Gynecologists recognize that the distention media using in diagnostic hysteroscopy often passes through patent fallopian tubes in to the pelvis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Diagnostic Hysteroscopy as a Tool for Diagnosis of Tubal Factor of Infertility in Comparison to Diagnostic Laparoscopy

Hefny

eldin

Abdel-Aziz

2020

Al-Azhar International Medical Journal

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Background: Fallopian tube obstruction is believed to play a role in 12-33% of subfertile couples. Therefore, the patency evaluation of fallopian tubes is a significant part of subfertile couple's work. Aim of the work: This work aims at comparing the sensitivity and specificity of the hysteroscopic assessment of tubal patency by the bubble test to diagnostic laparoscopy and hysterosalpingogram in infertile patients. Patients and Methods: A total of 100 women were recruited to the study during the period between January 2020 and June 2020. 100 patients underwent a diagnostic hysteroscopy followed by laparoscopy. Each Fallopian tube has been considered to be an individual case. Patency was evaluated in 200 Fallopian tubes. Results: A polyp was detected at three tubal orifice. Hyperemia was detected around two tubal orifice. Adhesions were detected at one tubal orifice. The tubes were patent in 113 cases with both methods. In 70 cases both laparoscopy and hysteroscopy found occluded tubes. The tubes were patent by laparoscopic dye in 10 cases, but could not be detected by hysteroscopy as such. Occlusion was observed by laparoscopy in 7 cases but patency was detected during hysteroscopy. Of the non-patent cases, 70 out of 77 laparoscopic findings were consistent with the hysteroscopic result, yielding a specificity estimate of 90.9% (95% CI 84.5% to 96.4%). Conclusion: Based on statistical analysis (sensitivity and specificity) of our data, diagnostic hysteroscopic bubble test is accurate and reliable compared to the laparoscopic test, which is considered a global standard criterion.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Diagnostic Hysteroscopy as a Tool for Diagnosis of Tubal Factor of Infertility in Comparison to Diagnostic Laparoscopy

Hefny

eldin

Abdel-Aziz

2020

Al-Azhar International Medical Journal

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“…Performing more procedures and analyzing the results could lead to being accepted as effective, precise and reproducible as laparoscopy. To evaluate sensitivity and specificity of the new method a comparative study was performed and results show that it is precise and accurate compared to the laparoscopic examination that is used as the "golden standard" worldwide [6]. Laparoscopic surgery should be worth considering only in cases of blockage in both tubes.…”

Section: Resultsmentioning

confidence: 99%

A Novel Method of Selective Chromopertubation at Office Hysteroscopy

Török¹

2016

J Gynecol Res Obstet

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Journal of Gynecological Research and Obstetrics 031 5.5 mm sheath (EMD Endoscopy Technologies). Normal saline (0.9% sodium chloride) is used for the distention, at controlled intrauterine pressure of 80-100 Hgmm. A digital camera is connected to the optic, so the results can be objectively evaluated and documented. The examination begins with a routine office hysteroscopy, during which any deformity of the uterine cavity and the endometrium can be visualized. Technique of pertubation In the second step a 1.7 mm plastic catheter (Cavafix, B-Braun) is inserted through the working channel of the sheath and the tip is placed to the tubal ostium (Figures 1,2). During selective pertubation, each Fallopian tube is considered as a diagnostic unit. By rotating the hysteroscope, the direction of the catheter can be modified toward the ostium. The cone shape of the tubal ostium will help in leading the tip of the flexible catheter into the ostium. The catheter should not to be inserted into the tube, only the tip should be placed at the entry of it. Through the catheter 2-10 ml of methylene blue dye (Patente Blue, 2 ml in 1000 ml saline) is injected slowly. In case of a patent Fallopian tube no blue fluid will appear in the uterine cavity. Normal color of the endometrium can be seen, while the transparent catheter turns blue, due to the methylene blue flowing inside it (Figure 3). Occluded Fallopian tube changes the uterine cavity into blue, due to the backflow of the methylene blue (Figure 4). In case of corneal occlusion, blue dye will flow back immediately. If the blockage is at the distal part of the tube, the first fraction of the blue dye will disappear and after some time of the injection will the back-flow be detectable. After the evaluation of tubal patency, blue dye clears up within 5-10 seconds

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“…At present, the most accurate diagnostic tool to evaluate tubal patency in infertile women is laparoscopy[ 7 ] that would be an invasive examination in combination with some necessary items, such as an equipped operating room, general anesthesia, laboratory test and trained staff, make laparoscopy an expensive and complex gold standard. [ 7 10 17 ] HSG is less invasive and widely used tool to detect fallopian tubal patency. [ 14 18 ] It used radiation and is associated with some complications such as allergic reactions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Efficacy of Transvaginal Sonography with Hysteroscopy for Assessment of Tubal Patency in Infertile Women Regarding Diagnostic Laparoscopy

2018

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Background:Infertility, as one of the most common gynecological disorders, affects many people worldwide. To choose the clinical treatment, correct assessment of tubal patency can provide an important clue; therefore, it is considered as one of the major steps in workup examinations of infertile women. In this study, we aimed to compare the results of transvaginal ultrasonography (TVS) after hysteroscopy (HSC) with laparoscopy, as a gold standard, for assessing the fallopian tubal patency in infertile women.Materials and Methods:This is a cross-sectional study which included 49 infertile women referred to Shahid Beheshti Hospital affiliated with Isfahan University of Medical Sciences during the years 2015 and 2016. At first, patients who met the inclusion criteria were examined through HSC in by a specialist in gynecology and obstetrics in operating room because laparoscopy was performed after TVS with HSC, but HSC was performed without anesthesia. TVS was performed before and after of HSC to observe fluid in the pouch of Douglas. The findings of TVS with HSC and laparoscopy were compared.Results:There was a strong agreement between TVS after HSC and laparoscopy (kappa coefficient = 0.935, 95% confidence interval [CI]: 0.81, 1.00). The sensitivity of TVS after HSC was 100% (95% CI: 66.37, 100) and specificity was 97.50% (95% CI: 86.84, 99.94) with a positive predictive value of 90% (95% CI: 55.50, 99.75) and negative predictive value of 100% (95% CI: 90.97, 100).Conclusion:TVS after HSC is an accurate diagnostic tool for examination of fallopian tubal patency in infertile women.

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Accuracy of Assessment of Tubal Patency With Selective Pertubation at Office Hysteroscopy Compared With Laparoscopy in Infertile Women

Cited by 35 publications

References 8 publications

Evaluation of Diagnostic Hysteroscopy as a Tool for Diagnosis of Tubal Factor of Infertility in Comparison to Diagnostic Laparoscopy

Evaluation of Diagnostic Hysteroscopy as a Tool for Diagnosis of Tubal Factor of Infertility in Comparison to Diagnostic Laparoscopy

A Novel Method of Selective Chromopertubation at Office Hysteroscopy

Evaluation of Efficacy of Transvaginal Sonography with Hysteroscopy for Assessment of Tubal Patency in Infertile Women Regarding Diagnostic Laparoscopy

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