title: Reevaluation of hysterosalpingography in infertility investigation.
abstract: The hysterosalpingogram has been extensively used in infertility investigations to assess tubal patency, however, the diagnostic reliability of this technique is not known. Two hundred thirty-one consecutive hysterosalpingograms were retrospectively evaluated. Sixty-two percent (143) of the patients subsequently underwent laparoscopy. Comparison of hysterosalpingogram and laparoscopic findings revealed a 15.9% false positive tubal patency rate and a 14.9% false negative tubal patency rate. Seventy-six percent of laparoscopies revealed previously undiagnosed intraperitoneal disease. Seventeen percent of hysterosalpingograms demonstrated intrauterine pathology. There was a 0.9% major complication rate with hysterosalpingograms due to two cases of acute pelvic inflammatory disease. No significant laparoscopic complications were noted. The results suggest that laparoscopy provides a more accurate assessment of tubal patency and peritoneal factors than hysterosalpingogram in the investigation of infertility.
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003951:Diagnostic Errors; D005069:Evaluation Studies as Topic; D005186:Fallopian Tube Patency Tests; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000209:etiology; D010535:Laparoscopy; D000292:Pelvic Inflammatory Disease / Q000517:prevention & control; D010538:Peritonitis / Q000517:prevention & control; D011292:Premedication
chemical_list: D000900:Anti-Bacterial Agents