Sensitivity of hysterosalpingography after tubal surgery
- 26 Downloads
Hysterosalpingography (HSG) to assess tubal patency in the post-operative evaluation of the infertile patient has been well described. However, the sensitivity and specificity of HSG after tubal surgery has not been reported. We correlated HSG and laparoscopic findings in 25 patients who had tubal surgery (microsurgical tubal reanastomoses  and distal salpingostomies ). HSG provided a more reliable means of assessing tubal patency (sensitivity and specificity of 96% and 61% respectively) than in detecting pelvic adhesive disease (PAD) (sensitivity and specificity of 12% and 75% respectively) regardless of tubal surgical procedure. HSG was associated with a high false negative rate (60%) due primarily to the inability to detect PAD. Complete agreement between HSG and laparoscopy was noted in only 15% of cases. These data suggest that HSG is a sensitive means to determine tubal patency, but was not sufficiently sensitive or specific to detect PAD after tubal surgery. These limitations should be noted in the interpretation of HSG in any infertile patient with a history of tubal surgery, and severely limits the application of HSG to the management of the post-operative infertile patient.
Key wordsPost-operative hysterosalpingography Laparoscopy
Unable to display preview. Download preview PDF.
- American Fertility Society (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian abnormalities and intrauterine adhesions. Fertil Steril 49:944–454Google Scholar
- Hulka JF (1985) Textbook of laparoscopy, 1st edn. Gruene and Stratton, Orlando, p 50–52Google Scholar
- Maathius JB, Norbach JGM, van Hall EV (1972) A comparison of the results of hysterosalpingography and laparoscopy in the diagnosis of fallopian tube dysfunction. Fertil Steril 23:428–431Google Scholar
- Schwimmer M, Heiken JP, McClennan BL, Friedrich ER (1985) Postoperative hysterosalpingography: radiologic-surgical correlation. Radiology 157–317Google Scholar
- Yoder IC (1988) Hysterosalpingography and pelvic ultrasound: imaging in infertility and gynecology, 1st edn. Little, Brown and Company, Boston, p 84–105Google Scholar