Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study - 15/04/21
, M Medina b, E Antolín c, C Ros d, A Amaro b, C De-Guirior c, d, N Manzour e, L Sotillo c, R De la Cuesta a, R Rodríguez c, L San-Frutos a, S Peralta b, A Martin-Martínez b, JL Alcázar eBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
OBJECTIVE |
To determine the feasibility,tolerability, and safety of the ultrasound assessment of tubal patency using foam as contrast.
METHODS |
This was a prospective multicenter study of 915 infertile nulliparous women scheduled for sonohysterosalpingography with foam instillation (HYFOSY) for tubal patency testing as a part of the fertility workup. Clinical and sonographic data were recorded into a web-shared database. Tubal patency, cervical catheterization, pain during the procedure and post-procedural complications were collected. Patients reported discomfort or pain experienced during the procedure with a visual analogue scale (VAS) score.
RESULTS |
Nine hundred fifteen women were included in the final analysis. Median age was 34 (range, 21−45) years and median body mass index was 23 (range, 16−41) kg/m2. Of 839 women, only 8(0.95 %) cases were abandoned due to impossibility of introducing the intracervical catheter. Most of the cervical os were easily cannulated with either paediatric nasogastric probes or special catheter for intrauterine insemination / sonohysterosalpingography 688/914(75.3 %). With a median instillation of 4 mL (range 1−16) of foam, both tubes were identified in 649/875 (70.9 %) patients, while unilateral patency was observed in 190/875 (20.8 %). Only 36/875 (3.9 %) of the women had bilateral tubal obstruction. The median VAS score for perception of pain during HyFoSy examination was 2 (range 0−10), and only 17 (1.9 %) of women reported severe pain (VAS ≥ 7). Pain was unrelated to tubal patency or tubal blockage. Unexpectedly, difficult cervical catheterizations that needed tenaculum, were more likely associated with mild pain during procedure [nasogastric probe group 176/289 (70.9 %) vs. insemination catheter group 166/399 (41.6 %) vs. tenaculum group 190/218(87.2 %) p < 0.001]. Finally, among 915 patients, we only noticed 3 (0.32 %) complications of the technique: two vasovagal episodes and a mild urinary infection.
CONCLUSION |
HYFOSY is a feasible, well-tolerated and safe technique for the evaluation of tubal patency in infertile women.
Le texte complet de cet article est disponible en PDF.Keywords : Tubal patency, Hysterosalpingocontrast sonography, Tolerability, Feasibility
Plan
Vol 50 - N° 5
Article 102004- mai 2021 Retour au numéro
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