Is Laparoscopy Still Necessary in the Management of Tubal Infertility?

• 作者: Abdoul Aziz Diouf Moussa Diallo Mame Diarra Ndiaye Aminata Niass Mamour Guèye Gnaza Tchindebe Anna Dia Magatte Mbaye Alassane Diouf
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: HYSTEROSALPINGOGRAPHY LAPAROSCOPY INFERTILITY Pelvic Adhesions
• 年，卷（期）: 2021,（2）
• 页码范围: 63-69
• 页数: 7页
• 分类号: R71

摘要

<strong>Objectives:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">To compare between hysterosalpingography (HSG) and laparoscopic findings in patients tested for infertility and thereby to determine the significance of the latter examination. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This was a descriptive study performed in two Gynecology departments in the Dakar (Senegal). Included were 84 patients with suspicious tubal-infertility who underwent HSG followed by laparoscopy. The Kappa (K) statistics was used to clarify the concordance between HSG vs. laparoscopy findings. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Kappa concordance between HSG and laparoscopy showed the followings: 0.08 for proximal tubal obstructions (poor agreement), 0.40 for distal tubal obstructions (moderate agreement), and -</span></span><span style="font-family:;" "=""><span><span style="font-family:Verdana;">0.08 for peritoneal adhesions (no agreement). Laparoscopy revealed pelvic adhesions in 84% of cases, pelvic endometriosis in 12% of cases, and apparently normal tubes in 12%. According to the distal tubal operability score, 16.6% of the lesions were classified as stage 4 and 23.8% at stage 1. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">HSG and laparoscopy findings did not agree in patients with tubal infertility, and thus, laparoscopy should be employed, especially when HSG showed abnormal findings. HSG has a low diagnostic value in adhesions.</span></span></span>