Comparative Study Between Hysterosalpingo-Contrast Sonography and Hysterosalpingography in Evaluating Tubal Patency at Aminu Kano Teaching Hospital, Kano. https://doi.org/10.60787/NMJ-64-5-189

Main Article Content

Ibrahim Danladi Muhammad https://orcid.org/0000-0001-6611-2951
Umar Suleiman Sabo
Sa’idu Adamu Ibrahim
Aliyu Dayyabu Labaran
Idris Usman Takai

Keywords

HyCoSy, HSG, Tubal patency, Assessment

Abstract

Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure. This study aimed to compare the effectiveness of Hysterosalpingocontrast Sonography (HyCoSy) using a saline and air mixture to HSG in assessing tubal patency in infertility patients at Aminu Kano Teaching Hospital.


Methodology: A cross-sectional study involved 50 consenting patients seeking fertility evaluation. The researchers used a semi-structured questionnaire to gather demographic information. HyCoSy with the saline and air mixture was performed between the 5th and 10th day of the menstrual cycle, followed by HSG within the next five days. The patency of each fallopian tube was assessed, and pain levels experienced during both procedures were recorded using a numerical rating scale.


Results: The results indicated that 68.8% of patients had bilateral patent tubes according to HyCoSy, while 60.4% were found to have patent tubes with HSG. A comparison of findings for individual tubes showed an 89.6% concordance rate between the two tests, with a Kappa index of 0.73, indicating substantial agreement. Importantly, patients reported significantly less pain during the HyCoSy procedure (mean NRS score of 4.1) compared to HSG (mean NRS score of 7.1).


Conclusion: This study demonstrated that HyCoSy using a saline and air mixture is highly comparable to HSG in assessing tubal patency. Notably, HyCoSy was preferred by patients due to its reduced pain and better tolerance, with minimal adverse effects. This suggests that HyCoSy may be a more patient-friendly and cost-effective alternative for tubal assessment in cases of infertility.

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References

1. Gelbaya TA, Potdar N, Jeve YB, Nardo LG. Definition and epidemiology of unexplained infertility. Obstet Gynecol Surv. 2014;69(2):109–15.

2. Saunders RD, Shwayder JM, Nakajima ST. Current methods of tubal patency assessment. Fertil Steril. 2011;95(7):2171–9.

3. Panchal S, Nagori C. Imaging techniques for assessment of tubal status. J Hum Reprod Sci. 2014;7(1):2–12.

4. Richman S, Viscomi N, Olsen L. Fallopian Ultrasound. 1984;507–10.

5. Exacoustos C, Zupi E, Carusotti C, Lanzi G. Hysterosalpingo-Contrast Sonography Compared with Hysterosalpingography and Laparoscopic Dye Pertubation to Evaluate Tubal Patency. J Am Assoc Gynecol Laparosc 2003;10(3):367-72.

6. Spalding H, Martikainen H, Tekay A, Jouppila P. Transvaginal salpingosonography for assessing tubal patency in women previously treated for pelvic inflammatory disease and benign ovarian tumors. Ultrasound Obstet Gynecol. 1999;14(3):205–9.

7. Volpi E, Zuccaro G, Patriarca A, Rustichelli S, Sismondi P. Transvaginal sonographic tubal patency testing using air and saline solution as contrast media in a routine infertility clinic setting. Ultrasound Obstet Gynecol. 1996; 7:43-48.

8. Yussman MA. Tests of Tubal Patency. Glob Libr Women’s Med. 2009;2228:1–18.

9. Rafal K, Bręborowicz G. Hysterosalpingo-contrast-sonography ( HyCoSy ) – a novel approach to female upper genital tract imaging and tubal patency assessment in outpatient clinic. Arc Perinat Med. 2007;13(3):17–22.

10. Hajian-tilaki K. Sample size estimation in diagnostic test studies of biomedical informatics. J Biomed Inform. 2014;48:193–204.

11. Moro F, Tropea A, Selvaggi L, Scarinci E, Lanzone A, Apa R. European Journal of Obstetrics & Gynecology and Reproductive Biology Hysterosalpingo-contrast-sonography ( HyCoSy ) in the assessment of tubal patency in endometriosis patients. Eur J Obstet Gynecol. 2015;186:22–5.

12. Luciano DE, Exacoustos C, Johns DA, Luciano AA. Can hysterosalpingo-contrast sonography replace hysterosalpingography in confirming tubal blockage after hysteroscopic sterilization and in the evaluation of the uterus and tubes in infertile patients  YMOB 2011;204(1):79.e1-79.e5.

13. Robertshaw IM, Sroga JM, Batcheller AE, Martinez AM, Winter TC, Sinning K, et al. Hysterosalpingo-contrast sonography with a saline-air device is equivalent to hysterosalpingography only in the presence of tubal patency. J Ultrasound Med. 2016;35(6):1215–22.

14. Marci R, Marcucci I, Marcucci AA, Pacini N, Salacone P, Sebastianelli A, et al. Hysterosalpingocontrast sonography ( HyCoSy ): evaluation of the pain perception, side effects and complications BMC Med Imaging. 2013;13:28. doi: 10.1186/1471-2342-13-28.

15. Hamed HO, Shahin AY, Elsamman AM. International Journal of Gynecology and Obstetrics Hysterosalpingo-contrast sonography versus radiographic hysterosalpingography in the evaluation of tubal patency. Int J Gynecol Obstet. 2009;105(3):215–7.

16. Savelli L, Pollastri P, Guerrini M, Villa G, Manuzzi L, Mabrouk M, et al. Tolerability, side effects, and complications of hysterosalpingocontrast sonography ( HyCoSy ). Fertil Steril. 2009;92(4):1481–6.

17. Graziano A, Lo G, Moscarini M, Marci R. Sonohysterosalpingography : a suitable choice in infertility workup. J Med Ultrason (2001). 2013;40(3):225-9. doi: 10.1007/s10396-012-0417-0.

18. Malik S, Alway SM, Gustafson K, Sanfilippo JS. Evaluation of tubal patency with the femvue™ saline-air device: are we ready to move back to the office. Fertil Steril. 2013;100(3):S384.

19. Ayida G, Harris P, Kennedy S, Seif M, Barlow D. Hysterosalpingo-contrast sonography ( HyCoSy ) using Echovist ’ -200 in the outpatient investigation of infertility patients. Br J Radiol. 1996;105(October):910–3.

20. Dijkman AB, Mol BWJ, Veen F Van Der, Bossuyt PMM, Hogerzeil H V. Can hysterosalpingocontrast-sonography replace hysterosalpingography in the assessment of tubal subfertility  Eur J Radiol. 2000 ;35(1):44-8.

21. Stacey C, Bown C, Dcr R, Manhire A. HyCoSy as good as claimed ? Br J Radiol. 2000;73:133–6.