Hysterosalpingography and laparoscopy: a comparative study.

Twenty-six women were evaluated with both hysterosalpingography and laparoscopy. The hysterosalpingograms were reviewed independently by two radiologists. Postdrainage films were obtained in 19 of 26 patients. A high false-negative rate (44.9% overall) and low specificity (20.6%) were observed. The postdrainage film contributed to a correct diagnosis in only four of 38 tubes evaluated by the first radiologist and in none evaluated by the second radiologist. Hysterosalpingography is valuable as a screening procedure for identifying abnormals but is not specific in differentiating tubal adhesions from tubal obstructions. It is recommended that preliminary films not be obtained routinely and that postdrainage films be reserved for cases where fluoroscopic and spot-film findings are equivocal.