Inki P, Palo P, Anttila L
Department of Obstetrics and Gynecology, Turku University Central Hospital, Finland.
Acta Obstet Gynecol Scand. 1998 Nov;77(10):978-82.
During the past few years, sonosalpingography has been suggested as the first-line method to study tubal patency. This study was launched in order to study the applicability of this method at our institution.
Thirty-two patients suffering from primary or secondary infertility were evaluated for tubal patency with sonosalpingography using a pediatric Foley urinary catheter and a combination of air and saline solution as a contrast medium. The uterine tubes were evaluated separately and the results were compared to the findings at laparoscopy and chromotubation performed independently. Four patients conceived before their scheduled laparoscopy and were excluded from the study. In addition, the patency of three Fallopian tubes could not be adequately evaluated, leaving altogether 53 uterine tubes that were evaluated by both methods.
The findings of both methods agreed in 47 out of 53 tubes (concordance, 88.7%). The sensitivity of sonosalpingography in diagnosing tubal patency was 90.2% and the specificity 83.3%. The positive predictive value for tubal patency by sonosalpingography was 94.9% and the negative predictive value 71.4%. Adverse events of sonosalpingography included moderate to severe abdominal pain in three patients, one vasovagal reaction, and one case of shoulder pain. No infectious complications were recorded.
The results confirm that sonosalpingography utilizing air and saline as a contrast medium is a reliable, simple and well-tolerated method to assess tubal patency in an outpatient setting. In addition, the procedure can be performed without prophylactic antibiotics using a regular pediatric Foley urinary catheter instead of an expensive hysterosalpingography catheter.
在过去几年中，输卵管超声造影已被建议作为研究输卵管通畅性的一线方法。本研究旨在探讨该方法在我们机构的适用性。
对32例原发性或继发性不孕症患者进行输卵管超声造影，以评估输卵管通畅性，使用小儿Foley尿管，并将空气和盐溶液混合作为造影剂。对双侧输卵管分别进行评估，并将结果与独立进行的腹腔镜检查和输卵管通液术的结果进行比较。4例患者在预定的腹腔镜检查前怀孕，被排除在研究之外。此外，3条输卵管的通畅性无法得到充分评估，共有53条输卵管通过两种方法进行了评估。
53条输卵管中有47条两种方法的结果一致（一致性为88.7%）。输卵管超声造影诊断输卵管通畅性的敏感性为90.2%，特异性为83.3%。输卵管超声造影对输卵管通畅性的阳性预测值为94.9%，阴性预测值为71.4%。输卵管超声造影的不良事件包括3例中度至重度腹痛、1例血管迷走神经反应和1例肩痛。未记录到感染并发症。
结果证实，以空气和盐水作为造影剂的输卵管超声造影是一种在门诊环境中评估输卵管通畅性的可靠、简单且耐受性良好的方法。此外，该操作可以使用常规小儿Foley尿管而非昂贵的子宫输卵管造影导管，无需预防性使用抗生素。
