Abstract
IntroductionThe objectives were to assess the diagnostic value of hysterosalpingography (HSG) with laparoscopy as gold standard in the evaluation of tubal patency and pelvic adhesions in women suffering from infertility.MethodsWe conducted a comparative cross sectional study on 208 medical files of infertile women followed up at the Yaoundé General Hospital during a period of five years (December 2007 to December 2012). Tubal patency, hydrosalpinx and pelvic adhesions detected at HSG were compared with laparoscopic findings as the gold standard. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of HSG were calculated with 95% confidence interval (CI).ResultsMean age of the patients was 31.4± 6.45 years. Secondary infertility was the most frequent type of infertility (66.82%). HSG had a moderate sensitivity (51.0%; 95% IC. 37.5-64.4), high specificity (90.0%; 95% IC.74.4-96.5), high PPV (89.3%; 95% IC. 72.8-96.3) and a moderate NPV (52.9%; 95% IC. 39.5-65.9) in the diagnosis of bilateral proximal tubal occlusion. Concerning, distal tubal patency, HSG had a high sensitivity (86.8%; 95% IC. 76.7-92.9), low specificity (42.2%; 95% CI. 29.0-56.7), moderate PPV (69.4%; 95% IC. 58.9-78.2) and a moderate NPV (67.9%; 95% IC. 49.3-82.0) in the diagnosis of bilateral or unilateral distal tubal occlusion. However, HSG had a low diagnostic value (27.8%; 95%IC.18.8-39.0) in the pelvic adhesions.ConclusionHSG is of limited diagnostic value in tubal factor infertility and is of low diagnostic value for pelvic adhesions.
Highlights
The objectives were to assess the diagnostic value of hysterosalpingography (HSG) with laparoscopy as gold standard in the evaluation of tubal patency and pelvic adhesions in women suffering from infertility
The aim of this study was to compare hysterosalpingograms to laparoscopy as gold standard in the diagnosis of tubal factors of female infertility at the Yaoundé General Hospital in Cameroon, in order to determine their diagnostic value in our context
This was a comparative cross-sectional study based on medical records of 208 women followed up for infertility at the Obstetrics and gynecology unit of the Yaoundé General Hospital (YGH) in Cameroon from December 2007 to December 2012.We included medical records of infertile women investigated by HSG and laparoscopy during the study period for assessment of tubal patency and pelvic adhesions
Summary
The objectives were to assess the diagnostic value of hysterosalpingography (HSG) with laparoscopy as gold standard in the evaluation of tubal patency and pelvic adhesions in women suffering from infertility. Conclusion: HSG is of limited diagnostic value in tubal factor infertility and is of low diagnostic value for pelvic adhesions. Tuboperitoneal factors are responsible for about 30-40% of cases of female infertility and evaluation of tubal patency represents a key step and a basic investigation in the assessment of infertile women [4,5]. The aim of this study was to compare hysterosalpingograms to laparoscopy as gold standard in the diagnosis of tubal factors of female infertility at the Yaoundé General Hospital in Cameroon, in order to determine their diagnostic value in our context
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