AI Summary & Key Takeaways
AI InsightAlthough L/S is more invasive technique than HSG, L/S with chromopertubation is the gold standard test for identifying periadnexal adhesive disease and endometriosis.
📌 3 Key Takeaways
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.
Özet
Amaç: Tubal faktör olgularında histerosalpingografi (HSG) ve laparoskopinin (L/S) uyumu ve infertilite etyolojisinde önemli yer tutan endometriozis hastalığının bulunma sıklığı araştırıldı. Gereç ve Yöntem: İnfertilite Kliniğinde 2006-2009 yılları arasında, HSG’de tubal faktör ön tanısı alan ve takiben L/S’ye alınan 139 hasta dahil edildi. HSG ve laparoskopi bulguları karşılaştırıldı. Ayrıca L/S’de endometriozis saptanan olguların tubal faktör varlığına göre dağılımı incelendi. Bulgular: Olguların ortalama yaşı 31.8±5.7, gravida 0 (0-5), infertilite süresi 30.7±3.7 ay, BMI 24.6±4.6 kg/m2 olarak bulundu. HSG’de unilateral tubal oklüzyon saptanan olguların % 38.8’de (n=38), bilateral tubal faktör saptanan olguların % 58.8’da (n=20) L/S’de tubal oklüzyon saptandı. HSG’de unilateral tubal oklüzyon saptanan olgularda tubal faktör bulunmama oranı bilateral tubal oklüzyon saptanan olgulara kıyasla anlamlı olarak fazla bulundu [(sırasıyla, % 61.2, % 51.2) (p: 0.001)]. L/S de tubal patoloji saptanmayan olgularda % 28.4 oranında endometriozis saptanırken, bu oran unilateral tubal faktör saptanan olgularda % 13.9, bilateral tubal faktör saptanan olgularda % 22.7 olarak bulundu. Gruplar arasında endometriozis insidansı bakımından fark bulunmadı (p=0.24). Sonuç: HSG infertil kadının değerlendirilmesinde ilk basamak tekniktir. Fakat, laparoskopi daha invaziv bir teknik olmasına rağmen, tubal tıkanıklıkları değerlendirmede gold standarttır.