The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis.
OBJECTIVE
To assess the value of hysterosalpingography (HSG) in diagnosing tubal patency and peritubal adhesions using laparoscopy with chromopertubation as the gold standard.


METHODS
Meta-analysis of 20 studies comparing HSG and laparoscopy for tubal patency and peritubal adhesions.


METHODS
Four thousand one hundred seventy-nine patients with infertility in 20 studies.


METHODS
Hysterosalpingography and diagnostic laparoscopy as part of infertility workup.


METHODS
Tubal patency and peritubal adhesions.


RESULTS
For tubal patency the reported sensitivity and specificity differed between studies. In a subset of studies that evaluated HSG and laparoscopy independently, a point estimate of 0.65 for sensitivity and 0.83 for specificity was calculated. For peritubal adhesions a summary receiver operating characteristic curve could be estimated.


CONCLUSIONS
Although HSG is of limited use for detecting tubal patency because of its low sensitivity, its high specificity makes it a useful test for ruling in tubal obstruction. For the evaluation of peritubal adhesions HSG is not reliable.
Swart
P
P
Department of Obstetrics and Gynaecology, University of Amsterdam, The Netherlands.
Mol
B W
BW
van der Veen
F
F
van Beurden
M
M
Redekop
W K
WK
Bossuyt
P M
PM
D005184:Fallopian Tube Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000706:statistics & numerical data*; D007247:Infertility, Female / Q000209:etiology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000175:diagnosis