<strong>Aim:</strong> <span style="font-family:""><span style="font-family:Verdana;">To evaluate whether hysterosalpingo-foam sonography (HyFoSy) can replace HSG as fir...<strong>Aim:</strong> <span style="font-family:""><span style="font-family:Verdana;">To evaluate whether hysterosalpingo-foam sonography (HyFoSy) can replace HSG as first-line evaluation for tubal patency in subfertile Indonesian patients by evaluating agreement level and comparing patients’ subjective complaints. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Twenty subfertile female patients at </span><i><span style="font-family:Verdana;">Cipto Mangunkusumo</span></i><span style="font-family:Verdana;"> Central General Referral Hospital (</span><i><span style="font-family:Verdana;">RSCM</span></i><span style="font-family:Verdana;">) from January 2018 to January 2019 were recruited conveniently to undergo both HSG and subsequent two-dimensional transvaginal HyFoSy after a minimum interval of 48 hours. Data on tubal patency and side effects inflicted by each examination within 24 hour</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> w</span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> collected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were 20 subjects enrolled in this study. In 2 subjects, stenosis of internal uterine ostium was identified on HyFoSy procedure. Out of 36 remaining tubes undergoing adequate tubal patency evaluation by HSG and HyFoSy, agreement was seen in 81% cases (kappa value 0.42). The discordant tubal evaluation results in 7 of 36 tubes w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:Verdana;"> associated with partial tubal obstruction, presence of co-existing gynaecological pathology, and tubal spasm. Less pain (p < 0.001) was experienced in HyFoSy as compared to HSG, with mean VAS of 1.8</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.4 cm and 5.4</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">2.4 cm, respectively. Seven of 20 patients experienced side effects due to HSG, such as abdominal cramp, spotting, backache, and bloating, in contrast to only one subject experiencing spotting due to HyFoSy. There was no hypersensitivity reaction observed in all subjects during HSG and HyFoSy procedure. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">HyFoSy has shown an excellent acceptance in Indonesian patients and could be a good alternative to replace HSG as a first line tubal patency examination.</span></span>展开更多
Background: Hysterosalpingogram (HSG) and Laparoscopy and dye tests for tubal assessment for a virgin who places high premium on her virginity could be challenging. Routine HSG may result in loss or damage to the hyme...Background: Hysterosalpingogram (HSG) and Laparoscopy and dye tests for tubal assessment for a virgin who places high premium on her virginity could be challenging. Routine HSG may result in loss or damage to the hymen and loss of virginity. Aim: The aim of the procedure of retrograde dye test was explored to see the possibility of assessing tubal patency during laparotomy. Case Presentation: At laparotomy and after myomectomy in a 32 year old virgin, a moderate sized Wilkinson’s cannula was gently inserted at the fimbrial end of the both tubes and 50mls of dilute Methylene-Blue solution was injected in each tube at a time to see whether the dye will appear at the vagina introitus. There was no resistance to flow of the dye in both tubes. Inspection of the vaginal introitus revealed a gush of dye flowing through it as the dye was introduced through each tube confirming the patency of both tubes. Conclusion: Retrograde dye test at the time of abdominal procedures like myomectomy, pelvic adhesiolysis and excision of endometriotic cyst can be cost effective. This procedure is also useful in assessing tubal patency for women who undergo laparotomy and also wish to preserve their virginity.展开更多
文摘<strong>Aim:</strong> <span style="font-family:""><span style="font-family:Verdana;">To evaluate whether hysterosalpingo-foam sonography (HyFoSy) can replace HSG as first-line evaluation for tubal patency in subfertile Indonesian patients by evaluating agreement level and comparing patients’ subjective complaints. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Twenty subfertile female patients at </span><i><span style="font-family:Verdana;">Cipto Mangunkusumo</span></i><span style="font-family:Verdana;"> Central General Referral Hospital (</span><i><span style="font-family:Verdana;">RSCM</span></i><span style="font-family:Verdana;">) from January 2018 to January 2019 were recruited conveniently to undergo both HSG and subsequent two-dimensional transvaginal HyFoSy after a minimum interval of 48 hours. Data on tubal patency and side effects inflicted by each examination within 24 hour</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> w</span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> collected. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were 20 subjects enrolled in this study. In 2 subjects, stenosis of internal uterine ostium was identified on HyFoSy procedure. Out of 36 remaining tubes undergoing adequate tubal patency evaluation by HSG and HyFoSy, agreement was seen in 81% cases (kappa value 0.42). The discordant tubal evaluation results in 7 of 36 tubes w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:Verdana;"> associated with partial tubal obstruction, presence of co-existing gynaecological pathology, and tubal spasm. Less pain (p < 0.001) was experienced in HyFoSy as compared to HSG, with mean VAS of 1.8</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.4 cm and 5.4</span><span style="font-family:""> </span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">2.4 cm, respectively. Seven of 20 patients experienced side effects due to HSG, such as abdominal cramp, spotting, backache, and bloating, in contrast to only one subject experiencing spotting due to HyFoSy. There was no hypersensitivity reaction observed in all subjects during HSG and HyFoSy procedure. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">HyFoSy has shown an excellent acceptance in Indonesian patients and could be a good alternative to replace HSG as a first line tubal patency examination.</span></span>
文摘Background: Hysterosalpingogram (HSG) and Laparoscopy and dye tests for tubal assessment for a virgin who places high premium on her virginity could be challenging. Routine HSG may result in loss or damage to the hymen and loss of virginity. Aim: The aim of the procedure of retrograde dye test was explored to see the possibility of assessing tubal patency during laparotomy. Case Presentation: At laparotomy and after myomectomy in a 32 year old virgin, a moderate sized Wilkinson’s cannula was gently inserted at the fimbrial end of the both tubes and 50mls of dilute Methylene-Blue solution was injected in each tube at a time to see whether the dye will appear at the vagina introitus. There was no resistance to flow of the dye in both tubes. Inspection of the vaginal introitus revealed a gush of dye flowing through it as the dye was introduced through each tube confirming the patency of both tubes. Conclusion: Retrograde dye test at the time of abdominal procedures like myomectomy, pelvic adhesiolysis and excision of endometriotic cyst can be cost effective. This procedure is also useful in assessing tubal patency for women who undergo laparotomy and also wish to preserve their virginity.