Lower Abdominal Pain During Office Hysteroscopy as a Guide in the Assessment of Tubal Patency in Infertile Women

Abstract

Objective: to test the accuracy of pain score measuring on each side of the lower abdomen for diagnosis oftubal patency.Material and Method: 60 patients underwent Office hysteroscopy and pain score on each side of the lowerabdomen was measured during hysteroscopy using Visual Analogue Score. Transvaginal ultrasonographywas done after hysteroscopy to assess the presence of fluid in Douglas pouch. One week later, laparoscopywas done as a reference test for tubal patency.Results: Pain score was significantly higher on the side of lower abdomen if the respective tube was patent(p value <.001). Area under ROC curve for the pain score test was 0.77 (95%CI: 0.85 to 0.9), p value <0.001denoting good accuracy. The optimum cutoff for pain score to discriminate tubal patency was >10 withsensitivity and specificity 79.8%and 93.6%, respectively.Conclusions: The pain score during hysteroscopy can be used to diagnose tubal patency. The optimumcutoff score is >10.