TITLE:
Is Laparoscopy Still Necessary in the Management of Tubal Infertility?
AUTHORS:
Abdoul Aziz Diouf, Moussa Diallo, Mame Diarra Ndiaye, Aminata Niass, Mamour Guèye, Gnaza Tchindebe, Anna Dia, Magatte Mbaye, Alassane Diouf
KEYWORDS:
Hysterosalpingography, Laparoscopy, Infertility, Pelvic Adhesions
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.2,
February
4,
2021
ABSTRACT: Objectives: To compare between hysterosalpingography (HSG) and
laparoscopic findings in patients tested for infertility and thereby to
determine the significance of the latter examination. Methods: This was
a descriptive study performed in two Gynecology departments in the Dakar
(Senegal). Included were 84 patients with suspicious tubal-infertility who
underwent HSG followed by laparoscopy. The Kappa (K) statistics was used to
clarify the concordance between HSG vs. laparoscopy findings. Results: Kappa
concordance between HSG and laparoscopy showed the followings: 0.08 for
proximal tubal obstructions (poor agreement), 0.40 for distal tubal
obstructions (moderate agreement), and -0.08 for peritoneal adhesions (no agreement). Laparoscopy revealed pelvic
adhesions in 84% of cases, pelvic endometriosis in 12% of cases, and apparently
normal tubes in 12%. According to the distal tubal operability score, 16.6% of
the lesions were classified as stage 4 and 23.8% at stage 1. Conclusion: HSG
and laparoscopy findings did not agree in patients with tubal infertility, and
thus, laparoscopy should be employed, especially when HSG showed abnormal
findings. HSG has a low diagnostic value in adhesions.