Dilşad HERKİLOĞLU, Canan KABACA

HİDROSALPİNKS TANISINDA ULTRASONOGRAFİ VE HİSTEROSALPİNGOGRAFİ YETERİNCE GÜVENİLİR Mİ?

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

Anahtar Kelimeler:

Hidrosalpinks, İnfertilte

ULTRASONOGRAPHY AND HYSTEROSALPHYNOGRAPHY RELIABLE IN THE DIAGNOSIS OF HYDROSALPİNX?

ULTRASONOGRAPHY AND HYSTEROSALPHYNOGRAPHY RELIABLE IN THE DIAGNOSIS OF HYDROSALPİNX?SUMMARYOBJECTIVE: 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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