title: Evaluation of time lapse for establishing distal tubal occlusion diagnosis during hysterosalpingography procedure performed by using water soluble contrast media.
abstract: BACKGROUND
  Hysterosalpingography (HSG) is the most frequently used diagnostic measure for simultaneously determining uterine abnormalities and tubal status among subfertile women. Despite several broader advantages such as availability and increased experience, the subjectivity involved during administration of the HSG procedure itself, and necessary imaging review, decreases the reliability and accuracy of HSG. In this study, we evaluated the time intervals between X-ray imaging during HSG procedure to establish the presence of distal tubal occlusion.
  
  
  METHODS
  Our study evaluated the HSG records of 89 women who underwent diagnostic laparoscopy for infertility work-up. Patients who were diagnosed with distal tubal occlusion upon receiving HSG and patients who demonstrated tubal patency on HSG were included in the study, to compare the time intervals in seconds from the tubal visualization view to the last fluoroscopic X-ray shot during the HSG procedure with tubal patency on diagnostic laparoscopy.
  
  
  RESULTS
  A statistically significant correlation regarding tubal patency between HSG procedures and diagnostic laparoscopy chromopertubation procedures was demonstrated. Although nearly statistically significant, the interval in seconds between the first HSG imaging and distal tubal filling was shorter for patients with patent tubes on diagnostic laparoscopy than patients with bilateral tubal occlusion (8.4±31.9 and 12.0±19.7, respectively; p=0.057). Time period intervals between the first and the last HSG, and between distal tubal filling to the last HSG of patients with patent tubes on diagnostic laparoscopy and patients with bilateral distal tubal occlusion were found to be statistically similar.
  
  
  CONCLUSIONS
  Although a trend exists towards shorter time period intervals between the first uterine visualization and distal tubal filling graphy among patients with tubal patency, rather than patients with distal tubal occlusion confirmed by diagnostic laparoscopy, clinically reliable objective time period intervals for finalizing the HSG procedure and proceeding with diagnostic laparoscopy due to distal tubal occlusion diagnosis on HSG could not be detected.
authors.affiliation: Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey. Electronic address: mdserkankahyaoglu@gmail.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Kahyaoglu
authors.affiliation: Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Omer Hamid
authors.initials: OH
authors.lastname: Yumusak
authors.affiliation: Department of Reproductive Endocrinology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Inci
authors.initials: I
authors.lastname: Kahyaoglu
authors.affiliation: Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Gokce Naz
authors.initials: GN
authors.lastname: Kucukbas
authors.affiliation: Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Alev
authors.initials: A
authors.lastname: Esercan
authors.affiliation: Department of Reproductive Endocrinology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Tasci
mesh_terms: D000328:Adult; D003287:Contrast Media; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods*; D007247:Infertility, Female / Q000000981:diagnostic imaging*; D013997:Time Factors
chemical_list: D003287:Contrast Media
keywords: diagnostic imaging; hysterosalpingography; reliability; tubal patency