title: Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We 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).
  
  
  RESULTS
  Mean 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.
  
  
  CONCLUSIONS
  HSG is of limited diagnostic value in tubal factor infertility and is of low diagnostic value for pelvic adhesions.
authors.affiliation: Obstetrics and Gynecology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroon; Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon.
authors.forename: Jean Dupont Kemfang
authors.initials: JD
authors.lastname: Ngowa
authors.affiliation: Obstetrics and Gynecology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroon; Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon.
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Kasia
authors.affiliation: Biostatistics Unit, Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon.
authors.forename: Nguefack-Tsague
authors.initials: NT
authors.lastname: Georges
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon.
authors.forename: Victorine
authors.initials: V
authors.lastname: Nkongo
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Yaoundé, Cameroon.
authors.forename: Charles
authors.initials: C
authors.lastname: Sone
authors.affiliation: Radiology Unit, Yaoundé General Hospital, P.O. Box 5408, Yaoundé, Cameroon.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Fongang
mesh_terms: D000328:Adult; D002163:Cameroon; D003430:Cross-Sectional Studies; D005184:Fallopian Tube Diseases / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D007247:Infertility, Female / Q000175:diagnosis* / Q000209:etiology; D010535:Laparoscopy / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis; D055815:Young Adult
keywords: Laparoscopy; adnexal adhesion; hysterosalpingography; infertility; tubal patency