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İnfertil Olgulara Minimal İnvaziv Yaklaşım ve Histerosalpingogramın Tanısal Değeri: Tek Merkez Deneyimleri

Year 2019, Volume: 16 Issue: 4, 211 - 213, 31.12.2019

Esra Isci Bostanci , Meryem Kuru Pekcan , Ümit Yasemin Sert , A.seval Özgü-erdinç , Hüseyin Yeşilyurt , Yaprak Ustun

Abstract

Amaç: Hastanemiz İnfertilite Kliniği’nde yapılan laparoskopik ve histeroskopik operasyonların endikasyon dağılımını belirlemek ve minimal invaziv operasyonların önemini saptamak.
Gereçler ve Yöntem: Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi İnfertilite Kliniği’nde, Ocak 2010- Aralık 2015 yılları arasında primer/sekonder infertil olgulara yapılan laparoskopik/histeroskopik operasyonlar retrospektif olarak incelenmiştir.
Bulgular: İnfertilite nedeniyle retrospektif olarak incelenen 729 hastanın 117’si (%16.1) tubal faktör, 244’ü (%33.5) endometriozis, 346’si (%47.4) endometrial polip, 21’i (% 2.9) submuköz myom ve 1 tanesi dermoid kist nedeniyle opere edilmiştir. Yapılan prosedürlere bakıldığında 188 adet laparoskopik kist ekstirpasyonu, 31 adet kist aspirasyonu, 1 adet laparoskopik adezyolizis, 4 adet endometriotik odak koterizasyonu, 120 adet diagnostik laparoskopi, 364 adet histeroskopik polipektomi ve 21 adet histeroskopik myomektomi operasyonu gerçekleştirilmiştir.
Tubal faktör ön tanısıyla alınan 117 hastanın 76’sında geçiş izlenmiş olup 41’inde geçiş tespit edilmemiştir. Bu bağlamda histerosalpingografinin pozitif prediktif değeri % 35.4 olarak hesaplanırken, negatif prediktif değeri ise % 64.6 olarak hesaplanmıştır.

Sonuç: Minimal invaziv cerrahi, günümüzde rutin uygulanımda yerini almıştır. Özellikle infertilite alanında, hastaları değerlendirme kolaylığı açısından altın standarttır. Bununla birlikte kullanımı tecrübe ve komplikasyonların üstesinden gelebilme yetisi gerektirmektedir.

Keywords

infertilite minimal invaziv yaklaşım

References

  • 1. Mosher W, Pratt W: Fecundity and infertility in the United States: incidence and trends. Fertil Steril, 56:192,1991.
  • 2. Develioglu O, Ozyurek E, Sadikoglu Y, Sadikoglu G, Tuncel E. Infertile women with bilateral obstructed tubes (A presentation of 7 cases). Gynecol Obstet Reprod Med 2006; 12(3): 186-88
  • 3. Tuarnaye H. Gamete source and manupulation. In Vayana E, Rowe PS. Griffin PD (eds), Current practices and controversies in assisted reproduction: report of a WHO, 2002, pp 83-101.
  • 4. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update. 2008; 14(6): 605-21.
  • 5. Ahmad Mahran, M.D., Ahmed R Abdelraheim, M.D., Abdelrahman Eissa, M.D., and Mohamed Gadelrab, M.D. Does laparoscopy still has a role in modern fertility practice?. Int J Reprod Biomed (Yazd). 2017 Dec; 15(12): 787–794.
  • 6. C. C. W. Chan, Ng E. H. Y., O. Tang, K. K. L. Chan, and P. C. Ho. “Comparison of three dimensional hysterosalpingo-contrast-sonography and diagnostic laparoscopy with chromopertuba-tion in the assessment of tubal patency for the investigation of subfertility” . Acta Obstetricia et Gynecologica Scandinavica, vol. 84, pp. 909-13, 2005.
  • 7. C. Exacoustos, A. Di Giovanni, B. Szabolcs, H. Binder-Reisinger, C. Gabardi, and D. Arduini. “Automated sonographictubal patency evaluation with three-dimensional coded con-trast imaging (CCI) during hysterosalpingo-contrast sonogra-phy (HyCoSy)”. Ultrasound in Obstetrics & Gynecology, vol. 34, no 5, pp 609-12, 2009.
  • 8. Loverro G, Nappi L, Vicino M, Carriero C, Vimercati A, Selvaggi L. Uterine cavity assesment in infertile women: comparison of transvaginal sonography and hysteroscopy. Eur J Obstet Gynecol Reprod Biol 2001; 100:67-71.
  • 9. Bergstrom S. Reproductive failure as a health priority in the Third World: a Review. East Afr Med J. 1992; 69(4):174-80.
  • 10. Leke RJ. The prevalence of infertility and its preventive measures in Sub-Saharan Africa, in: Sekadde-Kigondu C, Chikamata D, Franken D (eds). Management of Infertility in AFRO&EMRO Countries. Geneva, Switzerland: World Health Organization Proceedings of a workshop, 2002; 79-91.
  • 11. Simpson WL Jr, Beitia LG, Mester J. Hysterosalpingography: a reemerging study. Radiographics. 2006 Mar-Apr;26(2):419-31.
  • 12. Pavone ME1, Hirshfeld-Cytron JE, Kazer RR. The progressive simplification of the infertility evaluation. Obstet Gynecol Surv. 2011 Jan;66(1):31-41.
  • 13. Broeze KA, Opmeer BC, Van Geloven N, Coppus SF, Collins JA, Den Hartog JE, Van der Linden PJ, Marianowski P, Ng EH, Van der Steeg JW, Steures P, Strandell A, Van der Veen F, Mol BW. Are patient characteristics associated with the accuracy of hysterosalpingography in diagnosing tubal pathology? An individual patient data meta-analysis. Hum Reprod Update. 2011 May-Jun;17(3):293-300.
  • 14. Lim CP, Hasafa Z, Bhattacharya S, Maheshwari A. Should a Hysterosalpingogram Be a First-Line Investigation to Diagnose Female Tubal Sub fertility in the Modern Sub fertility Workup? Hum Reprod. 2011;26(5):967–71.
  • 15. Swart P, Mol BW, Van der Veen F, Van Beurden M, Redekop WK, Bossuyt PM. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995;64(3):486–91. 16. Goynumer G, Yetim G, Gokcen O, Karaaslan I, Wetherilt L, Durukan B. Hysterosalpingography, Laparoscopy or Both in the Diagnosis of Tubal Disease in Infertility. WJOLS. 2008;1(2):23–6.
  • 17. Tvarijonaviciene E, Nadisauskiene RJ. The value of hysterosalpingography in the diagnosis. Medicina (Kaunas) 2008;44(6):439–48.
  • 18. Ngowa JD, Kasia JM, Georges NT, Nkongo V, Sone C, Fongang E. Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon. Pan Afr Med J. 2015 Nov 19;22:264.
  • 19. Yücel B, Demirel E, Kelekçi S, Seçkin KD, Shawki O. Accuracy of a New Hysteroscopic Method in the Assessment of Tubal Patency: Hysteroscopic Chromotubation. Gynecol Obstet Reprod Med 2018: 24(2):82-86.
  • 20. Shushan A, Rojansky N. Should hysteroscopy be a part of the basic infertility workup? Hum Reprod 2000:7:1650
  • 21. Tur-Kaspa I, Gal M, Hartman J, Hartman A. A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1009 women with infertility or abnormal uterine bleeding. Fertil Steril 2006;6:1731-35.
  • 22. D’Hooghe TM, Debrock S, Hill JA, et al. Endometriozis and subfertility: is the relationship resolved? Semi Reprod Med 21:243, 2003.

Year 2019, Volume: 16 Issue: 4, 211 - 213, 31.12.2019

Esra Isci Bostanci , Meryem Kuru Pekcan , Ümit Yasemin Sert , A.seval Özgü-erdinç , Hüseyin Yeşilyurt , Yaprak Ustun

Abstract

References

  • 1. Mosher W, Pratt W: Fecundity and infertility in the United States: incidence and trends. Fertil Steril, 56:192,1991.
  • 2. Develioglu O, Ozyurek E, Sadikoglu Y, Sadikoglu G, Tuncel E. Infertile women with bilateral obstructed tubes (A presentation of 7 cases). Gynecol Obstet Reprod Med 2006; 12(3): 186-88
  • 3. Tuarnaye H. Gamete source and manupulation. In Vayana E, Rowe PS. Griffin PD (eds), Current practices and controversies in assisted reproduction: report of a WHO, 2002, pp 83-101.
  • 4. Ombelet W, Cooke I, Dyer S, Serour G, Devroey P. Infertility and the provision of infertility medical services in developing countries. Hum Reprod Update. 2008; 14(6): 605-21.
  • 5. Ahmad Mahran, M.D., Ahmed R Abdelraheim, M.D., Abdelrahman Eissa, M.D., and Mohamed Gadelrab, M.D. Does laparoscopy still has a role in modern fertility practice?. Int J Reprod Biomed (Yazd). 2017 Dec; 15(12): 787–794.
  • 6. C. C. W. Chan, Ng E. H. Y., O. Tang, K. K. L. Chan, and P. C. Ho. “Comparison of three dimensional hysterosalpingo-contrast-sonography and diagnostic laparoscopy with chromopertuba-tion in the assessment of tubal patency for the investigation of subfertility” . Acta Obstetricia et Gynecologica Scandinavica, vol. 84, pp. 909-13, 2005.
  • 7. C. Exacoustos, A. Di Giovanni, B. Szabolcs, H. Binder-Reisinger, C. Gabardi, and D. Arduini. “Automated sonographictubal patency evaluation with three-dimensional coded con-trast imaging (CCI) during hysterosalpingo-contrast sonogra-phy (HyCoSy)”. Ultrasound in Obstetrics & Gynecology, vol. 34, no 5, pp 609-12, 2009.
  • 8. Loverro G, Nappi L, Vicino M, Carriero C, Vimercati A, Selvaggi L. Uterine cavity assesment in infertile women: comparison of transvaginal sonography and hysteroscopy. Eur J Obstet Gynecol Reprod Biol 2001; 100:67-71.
  • 9. Bergstrom S. Reproductive failure as a health priority in the Third World: a Review. East Afr Med J. 1992; 69(4):174-80.
  • 10. Leke RJ. The prevalence of infertility and its preventive measures in Sub-Saharan Africa, in: Sekadde-Kigondu C, Chikamata D, Franken D (eds). Management of Infertility in AFRO&EMRO Countries. Geneva, Switzerland: World Health Organization Proceedings of a workshop, 2002; 79-91.
  • 11. Simpson WL Jr, Beitia LG, Mester J. Hysterosalpingography: a reemerging study. Radiographics. 2006 Mar-Apr;26(2):419-31.
  • 12. Pavone ME1, Hirshfeld-Cytron JE, Kazer RR. The progressive simplification of the infertility evaluation. Obstet Gynecol Surv. 2011 Jan;66(1):31-41.
  • 13. Broeze KA, Opmeer BC, Van Geloven N, Coppus SF, Collins JA, Den Hartog JE, Van der Linden PJ, Marianowski P, Ng EH, Van der Steeg JW, Steures P, Strandell A, Van der Veen F, Mol BW. Are patient characteristics associated with the accuracy of hysterosalpingography in diagnosing tubal pathology? An individual patient data meta-analysis. Hum Reprod Update. 2011 May-Jun;17(3):293-300.
  • 14. Lim CP, Hasafa Z, Bhattacharya S, Maheshwari A. Should a Hysterosalpingogram Be a First-Line Investigation to Diagnose Female Tubal Sub fertility in the Modern Sub fertility Workup? Hum Reprod. 2011;26(5):967–71.
  • 15. Swart P, Mol BW, Van der Veen F, Van Beurden M, Redekop WK, Bossuyt PM. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995;64(3):486–91. 16. Goynumer G, Yetim G, Gokcen O, Karaaslan I, Wetherilt L, Durukan B. Hysterosalpingography, Laparoscopy or Both in the Diagnosis of Tubal Disease in Infertility. WJOLS. 2008;1(2):23–6.
  • 17. Tvarijonaviciene E, Nadisauskiene RJ. The value of hysterosalpingography in the diagnosis. Medicina (Kaunas) 2008;44(6):439–48.
  • 18. Ngowa JD, Kasia JM, Georges NT, Nkongo V, Sone C, Fongang E. Comparison of hysterosalpingograms with laparoscopy in the diagnostic of tubal factor of female infertility at the Yaoundé General Hospital, Cameroon. Pan Afr Med J. 2015 Nov 19;22:264.
  • 19. Yücel B, Demirel E, Kelekçi S, Seçkin KD, Shawki O. Accuracy of a New Hysteroscopic Method in the Assessment of Tubal Patency: Hysteroscopic Chromotubation. Gynecol Obstet Reprod Med 2018: 24(2):82-86.
  • 20. Shushan A, Rojansky N. Should hysteroscopy be a part of the basic infertility workup? Hum Reprod 2000:7:1650
  • 21. Tur-Kaspa I, Gal M, Hartman J, Hartman A. A prospective evaluation of uterine abnormalities by saline infusion sonohysterography in 1009 women with infertility or abnormal uterine bleeding. Fertil Steril 2006;6:1731-35.
  • 22. D’Hooghe TM, Debrock S, Hill JA, et al. Endometriozis and subfertility: is the relationship resolved? Semi Reprod Med 21:243, 2003.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Esra Isci Bostanci 0000-0002-7703-7608

Meryem Kuru Pekcan 0000-0002-4144-2900

Ümit Yasemin Sert 0000-0003-0862-4793

A.seval Özgü-erdinç 0000-0002-6132-5779

Hüseyin Yeşilyurt 0000-0003-2688-9285

Yaprak Ustun 0000-0002-1011-3848

Publication Date December 31, 2019
Submission Date December 29, 2019
Acceptance Date December 31, 2019
Published in Issue Year 2019 Volume: 16 Issue: 4

Cite

Vancouver Isci Bostanci E, Pekcan MK, Sert ÜY, Özgü-erdinç A, Yeşilyurt H, Ustun Y. İnfertil Olgulara Minimal İnvaziv Yaklaşım ve Histerosalpingogramın Tanısal Değeri: Tek Merkez Deneyimleri. JGON. 2019;16(4):211-3.
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