Long term safety of fluoroscopically guided selective salpingography and tubal catheterization.
BACKGROUND
The irradiation of the ovaries of reproductive age women during fluoroscopically guided selective salpingography and tubal catheterization has raised concern about the safety of the procedure. In addition to the risk of cancer induction, which exists with the irradiation of all tissues, with the gonads, the induction of hereditary disorders is possible. The objective of this study was to estimate these risks and present them in a clinically meaningful way.


METHODS
Retrospective analysis was undertaken of 366 consecutive cases of selective salpingography and tubal catheterization performed at the Birmingham Women's Hospital, UK. The radiation doses of different types of procedure were compared with the background annual radiation dose. The risks of cancer and genetic disorders induction were calculated using conversion coefficients published by the International Commission on Radiological Protection.


RESULTS
The radiation dose women were exposed to during selective salpingography and tubal catheterization under fluoroscopic guidance was a fraction of the background annual radiation dose. The excess lifetime risks of cancer and hereditary disorders were in the order of four to 13 and two to six per million procedures respectively.


CONCLUSIONS
The long term risks of selective salpingography and tubal catheterization under fluoroscopic guidance are low.
Papaioannou
S
S
Birmingham Women's Hospital, Metchley Park Road, Birmingham, UK. Spyrospap@talk21.com
Afnan
M
M
Coomarasamy
A
A
Ola
B
B
Hammadieh
N
N
Temperton
D H
DH
McHugo
J M
JM
Sharif
K
K
D000328:Adult; D002404:Catheterization / Q000379:methods*; D005187:Fallopian Tubes; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D030342:Genetic Diseases, Inborn / Q000209:etiology; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects* / Q000379:methods*; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology; D011874:Radiometry; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D013997:Time Factors