HİDROSALPİNKS TANISINDA ULTRASONOGRAFİ VE HİSTEROSALPİNGOGRAFİ YETERİNCE GÜVENİLİR Mİ?

Year 2018, , 218 - 222, 27.06.2018

Dilşad Herkiloğlu , Canan Kabaca

https://doi.org/10.16948/zktipb.416720

Abstract

HİDROSALPİNKS TANISINDA
ULTRASONOGRAFİ VE HİSTEROSALPİNGOGRAFİ YETERİNCE GÜVENİLİR Mİ?

 

ÖZET

 

AMAÇ:İnfertil
hastaların uterin boşluğu ve fallop tüplerini ilk basamak değerlendirme ultrasonografi
(USG) ile olup bir sonraki aşamada diğer gelişmiş ve etkili yöntemler olmasına
rağmen histerosalpingografi (HSG) ucuz, kolaylıkla erişilebilir ve yorumlanması
kolay olduğundan yaygın olarak kullanılmaktadır. Çalışmamızda HSG ve USG
sonucunda hidrosalpinks ön tanısı konulan hastaların laparoskopi ile
korelasyonunu değerlendirerek HSG’nin ve USG’nin hidrosalpinks tanısı koymadaki
değeri ve birbirlerine üstünlüğü olup olmadığını  göstermeyi amaçladık.

YÖNTEM:Çalışmaya
1 Ağustos 2015 ile 1 Nisan 2017 tarihleri arasında hastanemizin kadın doğum
polikliniklerine infertilite nedeniyle ile başvuran HSG’de ya da USG’de
hidrosalpinks saptanan 48 hasta dahil edildi. Tüm hastalar genel anestezi
altında, laparoskopi ile opere edildi. Laparoskopide her iki tuba serbest  metilen mavisi geçişi değerlendirildi. HSG
veya USG sonucu ile laparoskopi sonucunun korele olmaması HSG’nin ya da USG’nin
yanlış teşhisi olarak değerlendirildi. 
Laparoskopide patolojik bulguların olması halinde HSG ya da USG teşhisi
doğru olarak kabul edildi.

 

BULGULAR:48
hastanın 30’u primer infertil 18’i sekonder infertildi. 26 hastaya HSG ile
hidrosalpinks düşünüldü. Laparoskopi sonrası 15’inde (%57,7) hidrosalpinks
doğrulandı. 25 hastaya USG ile hidrosalpinks ön tanısıyla laparoskopi yapıldı.
17’sinde (%68)  hidrosalpinks doğrulandı.
3 hastada hem USG de hemde HSG de hidrosalpinks mevcuttu. Bu hastalarda USG
bulgularının laparoskopi ile korelasyonu değerlendirildi. Hsg’nin teşhis
doğruluğu (%57,7) USG’nin teşhis doğruluğu (%68) ile arasında istatistiksel bir
fark saptanmadı. (P=0,638). 

SONUÇ: İnfertilitenin
ilk basamak değerlendirmelerinden olan USG ve HSG ile ucuz ve kolay bir şekilde
hidrosalpinks tanısı konulabilir.

 

Anahtar
sözcükler: Hidrosalpinks, İnfertilte, Laparoskopi

 

Keywords

Hidrosalpinks, İnfertilte

ULTRASONOGRAPHY AND HYSTEROSALPHYNOGRAPHY RELIABLE IN THE DIAGNOSIS OF HYDROSALPİNX?

Abstract

ULTRASONOGRAPHY AND
HYSTEROSALPHYNOGRAPHY RELIABLE IN THE DIAGNOSIS OF HYDROSALPİNX?

SUMMARY

OBJECTIVE: Although the first step
evaluation of infertile patients with uterine cavity and fallopian tubes is
ultrasonography (USG), hysterosalpingography (HSG) is widely used because it is
cheap, easily accessible and easy to interpret, although other advanced and effective
methods are available at the next stage. In our study, we aimed to evaluate the
correlation of HSG and USG with laparoscopy of patients with hydrosalpinx presumptive
diagnosis and to show whether HSG and USG are superior to each other in
hyphrosalpinx diagnosis.

METHODS: Between August 1, 2015 and
April 1, 2017, 48 patients who were admitted to our obstetric gynecology out patient
clinic for infertility, or who underwent hydrosalpinx in USG were included in
the study. All patients underwent laparoscopy under general anesthesia.
Laparoscopy was used to evaluate the incidence of free methylene blue in both
tuba. Correlation of HSG or USG result with laparoscopy result was assessed as
false diagnosis of HSG or USG. In the case of pathological findings on
laparoscopy, HSG or USG diagnosis was accepted correctly.

RESULTS: Of the 48 patients, 30 were primer
infertile 18 were secondary to infertile. 26 patients were considered hydrosalpinx
with HSG. Hydrosalpinx was confirmed in 15 (57.7%) of the patients after laparoscopy.
Twenty-five patients underwent laparoscopy with USG and hydrosalpinx anterior diagnosis.
In 17 (68%) hydrosalpinx was confirmed. In 3 patients, both USG and HSG had
hydrosalpinx. The correlation of USG findings with laparoscopy was evaluated in
these patients. There was no statistically significant difference between the diagnostic
accuracy of HSG (57.7%) and the diagnostic accuracy of USG (68%). (P = 0.638).

CONCLUSION: USG and HSG, which are the
first-line evaluations of infertility, can diagnose hydrosalpinx cheaply and easily.

Keywords

Hydrosalpinx, Infertility

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