EVALUATION OF COMPARATIVE EFFICACY AND ADVERSE EVENTS OF DIAGNOSTIC HYSTEROLAPAROSCOPY WITH HYSTEROSALPINGOGRAPHY FOR DETECTION OF PELVIC, UTERINE AND TUBAL PATHOLOGY IN PRIMARY AND SECONDARY INFERTILITY CASES.

Dr. Siddharth Srivastava, Dr. Arun Gupta, Dr. Aishwarya Srivastava

Abstract


Introduction: One of the most important and underappreciated reproductive health problems in developing countries is the high rate of infertility and childlessness

Objective: 1. To study the diagnostic efficacy of HSG compared to Diagnostic Hysterolaparoscopy for detection of Uterine and Tubal Pathology in Primary and Secondary infertility cases.

2. To assess the utility of diagnostic hysterolaparoscopy as one step procedure for detection of Pelvic, Uterine and Tubal Pathology in female infertility cases.

3. To compare the adverse events/complications of Hysterosalpingography and Diagnostic Hysterolaparoscopy.

Methodology: The study began after receiving Ethic Committee approval and by taking informed consent of the participants. We enrolled 140 patients diagnosed with Primary or secondary Infertility and attending Obstetric and Gynaecology department of Geetanjali Medical College and Hospital All the patients were enrolled by checking inclusion and exclusion criteria. Patients with Primary and Secondary infertility were enrolled in the study. Each patient undergone Hysterosalpingography followed by Hysterolaparoscopy procedure. Hysterosalpingography findings was compared with hysterolaparoscopic findings for understanding pelvic. tubal and uterine pathology. P value less than 0.05 was considered as statistically significant. 

Result: A total of 140 patients recruited in our study. The mean age group in our patient was 27.93±4.08 years. The most common age group was 21-30 years. Primary infertility was most common in our patients. The mean duration of infertility in our patient was 5.49 years and standard deviation was 2.86 years. HSC was 100% sensitive than HSG for uterine pathology. HSG was 60.31% sensitive for tubal patency as compared to laproscopic chromopertbation. HSG is associated with high amount of complications as seen in our study with more chances of intravasation of dye and pain, while in Hysterolaproscopy pain and in only one patient port site infection was seen.

Conclusion: Hysterolaparoscopy is far superior to HSG, as it is more accurate and therapeutic intervention is possible at the same time.


Keywords


Hysteroscopy, hysterosalpingography, Infertility

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