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Nguyen E, Strug M, Gardner A, Burney R, Campbell S, Aghajanova L. Initial fertility evaluation with saline sonography vs. hysterosalpingography: it is debate-tubal. Fertil Steril 2024; 121:922-930. [PMID: 38703168 DOI: 10.1016/j.fertnstert.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Edward Nguyen
- Division Reproductive Endocrinology and Infertility, Stanford University School of Medicine, Sunnyvale, California
| | - Michael Strug
- Division Reproductive Endocrinology and Infertility, Stanford University School of Medicine, Sunnyvale, California
| | - Austin Gardner
- Division Reproductive Endocrinology and Infertility, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard Burney
- Division Reproductive Endocrinology and Infertility, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sukhkamal Campbell
- Division Reproductive Endocrinology and Infertility, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lusine Aghajanova
- Division Reproductive Endocrinology and Infertility, Stanford University School of Medicine, Sunnyvale, California
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Serrano González L, Pérez-Medina T, Bueno Olalla B, Royuela A, De La Cuesta MDLR, Saéz de la Mata D, Domínguez-Franjo E, Calles-Sastre L, Engels V. Is hysterosalpingo-foam sonography (HyFoSy) more tolerable in terms of pain and anxiety than hysterosalpingography (HSG)? A prospective real-world setting multicentre study. BMC Womens Health 2022; 22:41. [PMID: 35152893 PMCID: PMC9909448 DOI: 10.1186/s12905-022-01606-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/25/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In 60% of sterile couples a female factor is present, with these being tubal factors in 30-50% of cases. A tubal patency test is also required in women without a male partner undergoing fertility treatment. Thus, an accurate, safe and tolerable technique should be available. The aim of this study is to determine and to compare hysterosalpingo-foam sonography (HyFoSy) and hysterosalpingography (HSG) tolerability in terms of pain and anxiety. METHODS This is a prospective real-world setting multicentre study conducted in two tertiary hospitals in Madrid. 210 infertile women/women without a male partner looking to get pregnant were recruited; 111 for the HyFoSy group and 99 for the HSG group. Tolerability was measured in terms of anxiety by the State Trait Anxiety Inventory (STAI) and pain by the Visual Analogue Scale (VAS). RESULTS Median VAS score in HyFoSy group was 2 (P25; P75: 1; 3) versus 5 (4; 8) in HSG group, p < 0.001. The median State-STAI score in the HSG group was 18 points (10; 26) versus 10 (7; 16) in the HyFoSy group (p < 0.001); the median Trait-STAI score in the HSG group was 15 (11; 21) versus 13 (9; 17) in the HyFoSy group (p = 0.044). CONCLUSIONS HyFoSy shows higher tolerability to both: pain and anxiety. It is related to less pain and less post-test anxiety than HSG.
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Affiliation(s)
- Lucía Serrano González
- Department of Gynaecology and Obstetrics, Puerta de Hierro Majadahonda University Hospital, Joaquín Rodrigo St, 1, 28222, Majadahonda, Madrid, Spain. .,Department of Gynaecology and Obstetrics, Hospital Universitario Ramón y Cajal, M-607, km. 9, 100, 28034, Madrid, Madrid, Spain.
| | - Tirso Pérez-Medina
- grid.411171.30000 0004 0425 3881Department of Gynaecology and Obstetrics, Puerta de Hierro Majadahonda University Hospital, Joaquín Rodrigo St, 1, 28222 Majadahonda, Madrid Spain
| | - Beatriz Bueno Olalla
- Department of Gynaecology and Obstetrics, Infanta Sofía University Hospital, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid Spain
| | - Ana Royuela
- grid.466571.70000 0004 1756 6246Biostatistics Unit, Biomedical Research Institute Puerta de Hierro-Segovia de Arana (CIBERESP) ES, Joaquín Rodrigo St, 1, 28222 Majadahonda, Madrid Spain
| | - María de los Reyes De La Cuesta
- grid.411171.30000 0004 0425 3881Department of Gynaecology and Obstetrics, Puerta de Hierro Majadahonda University Hospital, Joaquín Rodrigo St, 1, 28222 Majadahonda, Madrid Spain
| | - David Saéz de la Mata
- Department of Gynaecology and Obstetrics, Infanta Sofía University Hospital, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid Spain
| | - Esther Domínguez-Franjo
- Department of Radio Diagnosis, Infanta Sofía University Hospital, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid Spain
| | - Laura Calles-Sastre
- grid.411171.30000 0004 0425 3881Department of Gynaecology and Obstetrics, Puerta de Hierro Majadahonda University Hospital, Joaquín Rodrigo St, 1, 28222 Majadahonda, Madrid Spain
| | - Virginia Engels
- grid.411171.30000 0004 0425 3881Department of Gynaecology and Obstetrics, Puerta de Hierro Majadahonda University Hospital, Joaquín Rodrigo St, 1, 28222 Majadahonda, Madrid Spain
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Melcer Y, Gat I, Dvash S, Copel L, Pekar-Zlotin M, Youngster M, Maymon R. Tubal patency assessment using sequential transvaginal ultrasound and hysterosalpingo-foam sonography after methotrexate treatment for tubal pregnancy. Reprod Biomed Online 2021; 44:310-315. [PMID: 34906423 DOI: 10.1016/j.rbmo.2021.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022]
Abstract
RESEARCH QUESTION What is the efficacy of sequential two-dimensional transvaginal ultrasound (2D-US) and hysterosalpingo-foam sonography (HyFoSy) after methotrexate (MTX) treatment for tubal pregnancy among patients who desire a future pregnancy? DESIGN A prospective trial conducted between May 2019 and November 2020. Patients who had a suspected tubal ectopic pregnancy diagnosed by ultrasound and treated by MTX were included. These patients underwent sequential transvaginal 2D-US assessment of the pelvic organs and a complementary HyFoSy for tubal patency. The primary outcome was tubal obstruction in the affected side. RESULTS A total of 360 women underwent sequential transvaginal 2D-US assessment of the pelvic organs and a complementary HyFoSy for tubal patency. Of these, 40 (11.1%) women fulfilling the inclusion criteria were enrolled. In six out of 40 (15%), hydrosalpinx of the affected tube was found during the initial transvaginal ultrasound examination and were excluded from further investigation. In the remaining 34 (85%) patients, HyFoSy was carried out. Tubal block was found in 10 out of 34 (29.4%) patients. Of these, eight out of 34 (23.5%) and two out of 34 (5.9%) had a proximal block of the affected tube and bilateral proximal obstruction, respectively. Hysterosalpingography confirmed the tubal obstruction in all the affected cases. No procedure-related complications were documented. CONCLUSIONS Forty per cent of women who were treated by MTX for tubal pregnancy were diagnosed with tubal obstruction. We recommend that sequential transvaginal ultrasound and HyFoSy become part of routine follow-up for these women, thus offering them timely referral to the appropriate specialist.
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Affiliation(s)
- Yaakov Melcer
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel.
| | - Itai Gat
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
| | - Shira Dvash
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
| | - Laurian Copel
- Department of Radiology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
| | - Marina Pekar-Zlotin
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
| | - Michal Youngster
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Zerifin 70300, Israel
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Melcer Y, Zilberman Sharon N, Nimrodi M, Pekar-Zlotin M, Gat I, Maymon R. Hysterosalpingo-Foam Sonography for the Diagnosis of Tubal Occlusion: A Systematic Review and Meta-analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:2031-2037. [PMID: 33368463 DOI: 10.1002/jum.15607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/18/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
This systematic review and meta-analysis evaluated the diagnostic accuracy of hysterosalpingo-foam sonography in suspected cases of tubal occlusion. The combined sensitivity and specificity estimates were 0.99 (95% confidence interval [CI], 0.89-0.99) and 0.91 (95% CI, 0.53-0.98), respectively, with positive and negative likelihood ratios of 11.5 (95% CI, 1.5-87.5) and 0.006 (95% CI, 0.0003-0.12), respectively. The diagnostic odds ratio was 1931.008 (95% CI, 69.7-53,460.8). These findings confirm hysterosalpingo-foam sonography as a highly accurate test for the diagnosis of tubal occlusion and show that it is on a par with standard tests.
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Melcer Y, Nimrodi M, Levinsohn-Tavor O, Gal-Kochav M, Pekar-Zlotin M, Maymon R. Analgesic Efficacy of Intrauterine Lidocaine Flushing in Hysterosalpingo-foam Sonography: A Double-blind Randomized Controlled Trial. J Minim Invasive Gynecol 2020; 28:1484-1489. [PMID: 33249268 DOI: 10.1016/j.jmig.2020.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To evaluate the efficacy of flushing the uterine cavity with lidocaine before hysterosalpingo-foam sonography (HyFoSy) to reduce procedure-related pain. DESIGN A double-blind randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Shamir Medical Center, Israel between June 2020 and September 2020 involving 80 women undergoing a HyFoSy procedure. SETTING University-affiliated medical center. PATIENTS A total of 40 women were assigned randomly to the lidocaine group and 40 to the saline (placebo) group using a predetermined randomization code. Intrauterine instillation before the procedure consisting of either lidocaine 2% or normal saline alone was conducted, respectively. INTERVENTIONS The primary outcome measure was the visual analog scale (VAS) pain score during the phase of intrauterine foam instillation reported by the women after the procedure. The VAS consisted of a 10-cm line ranging from 0 to 10 (anchored by 0 = no pain and 10 = very severe pain). On the basis of the VAS scores, the pain level ratings were classified as mild (rated 1-3), moderate (4-6), or severe (7-10). MEASUREMENTS AND MAIN RESULTS The patient characteristics and obstetric data were found to be similar in both groups. Comparison of the VAS pain scores experienced during the procedure showed that women in the lidocaine flushing group rated the procedure less painful than the women in the saline group (3.0 ± 1.3 vs 6.3 ± 1.5, respectively; p = .001). The incidence of severe pain was significantly lower in the lidocaine group than the saline group (2.5% and 45.0%, respectively, p = .001). CONCLUSION Lidocaine flushing of the uterine cavity before HyFoSy significantly decreased the pain known to be caused by this procedure and had the advantage of no side effects. It is easily applied, relatively inexpensive, and may affect compliance with this procedure.
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Affiliation(s)
- Yaakov Melcer
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)..
| | - Maya Nimrodi
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)
| | - Orna Levinsohn-Tavor
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)
| | - Maayan Gal-Kochav
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)
| | - Marina Pekar-Zlotin
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)
| | - Ron Maymon
- From the Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (formerly Assaf Harofeh Medical Center), affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (all authors)
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Zhang N, Liu Y, He Y, Shi J, Zhou M, Liu H. Transvaginal four-dimensional hysterosalpingo-contrast sonography: Pain perception and factors influencing pain severity. J Obstet Gynaecol Res 2020; 47:302-310. [PMID: 33107172 DOI: 10.1111/jog.14538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/23/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
AIM The purpose is to investigate pain perception during transvaginal four-dimensional hysterosalpingo-contrast sonography (TV 4D-HyCoSy) and factors influencing pain severity. METHODS This was a retrospective study included 340 women who underwent TV 4D-HyCoSy examination from January 2016 to October 2017. The factors were recorded, including age, childbearing history, infertility type, history of pelvic inflammation, pelvic surgery, history of uterine manipulation, history of ectopic pregnancy, atropine delivery mode, uterine position, uterine malformation, uterine lesion, fibroid, intrauterine adhesion, polycystic ovary, endometrial implantation cyst, dysmenorrhea score, the degree of patency of fallopian tube and contrast agents dosage. Pain was evaluated during and after TV 4D-HyCoSy. The time point of peak pain was evaluated and the influencing factors of moderate/severe pain were analyzed. RESULTS The highest pain occurred at contrast instillation. The independent influencing factors of moderate/severe pain were age (P = 0.021), dysmenorrhea score (P = 0.003) and tubal patency (P < 0.001). Further analysis showed that age affected the pain score when TV 4D-HyCoSy started and the peak pain occurred. Dysmenorrhea score and tubal patency affect the pain score at most time points. CONCLUSION Age, dysmenorrhea score and tubal patency are factors influencing the severity of pain during TV 4D-HyCoSy.
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Affiliation(s)
- Ning Zhang
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yu Liu
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yanni He
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Jiayao Shi
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Meijun Zhou
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hongmei Liu
- Department of Ultrasonography, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Exalto N, Emanuel MH. Clinical Aspects of HyFoSy as Tubal Patency Test in Subfertility Workup. BIOMED RESEARCH INTERNATIONAL 2019; 2019:4827376. [PMID: 31360713 PMCID: PMC6644241 DOI: 10.1155/2019/4827376] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/04/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Tubal patency testing is an essential part of female subfertility evaluation. Traditionally, hysterosalpingography (HSG) was the first step to evaluate tubal patency. However, during the past decade Hysterosalpingo-Contrast Sonography (HyCoSy) was introduced in order to avoid radiation exposure and Hysterosalpingo-Foam Sonography (HyFoSy) has been developed as a safe and less painful alternative. OBJECTIVES AND RATIONALE The aim of this narrative review is to provide an overview of the currently available HyFoSy literature and related clinical aspects. SEARCH METHODS A literature search was conducted using PubMed and Embase from the introduction of HyFoSy to March 2019. Unfortunately, a meta-analysis was not possible due to a too small number of studies, being mutually incomparable for the various subjects of clinical aspects, even for the reliability as a test for tubal patency. OUTCOMES Nine small studies concluded that the accuracy and effectiveness as a test for tubal patency of 2D- and 3D-HyFoSy are comparable or even better than HSG or HyCoSy. With or without using Doppler techniques, 3D-HyFoSy does not seem to offer benefits above real-time 2D-HyFoSy. Five studies reported on pain and discomfort during HyFoSy, concluding that HyFoSy is a well-tolerated, less painful procedure compared to HSG, without a need for the use of analgesics. There are suggestions about an increased pregnancy rate in the first three cycles after the procedure but in no studies pregnancy outcome after HyFoSy was compared with other or no intervention. WIDER IMPLICATIONS HyFoSy is a promising and safe alternative for HSG with regard to accuracy and effectiveness. HyFoSy lacks radiation and iodine exposure and is a well-tolerated and less painful procedure than HSG, without the need for analgesics. However more research is needed to make clear statements regarding a therapeutic effect of HyFoSy.
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Affiliation(s)
- Niek Exalto
- Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Mark Hans Emanuel
- Division of Woman and Baby, Department of Gynaecology and Reproductive Medicine, University Medical Centre, Utrecht, Netherlands
- Department of (Uro)gynaecology, University Hospital, Ghent, Belgium
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Handelzalts JE, Levy S, Peled Y, Binyamin L, Wiznitzer A, Goldzweig G, Krissi H. Information seeking and perceptions of anxiety and pain among women undergoing hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 2016; 202:41-4. [PMID: 27160813 DOI: 10.1016/j.ejogrb.2016.04.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/12/2016] [Accepted: 04/23/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Hysterosalpingography (HSG) is an accepted diagnostic tool for infertility workup and is considered an invasive procedure that is generally regarded as uncomfortable and painful, though research on psychological consequences is scarce and outdated. The study objective was to investigate women's experience of HSG in terms of fear, anxiety and pain, as compared to colposcopy. STUDY DESIGN This cross sectional questionnaire study was conducted at two public women's health clinics in Israel between January 2013 and March 2014. 137 women were included in the study. 42 consecutively sampled women referred for outpatient HSG and 95 consecutively sampled women referred for outpatient diagnostic colposcopy. The main outcome measures were: state-trait anxiety, information seeking behavior, fear of pain, fear of the results, retrospective pain. RESULTS Compared to those undergoing colposcopy, women undergoing HSG expressed significantly higher anxiety prior to the procedure, feared the pain involved more, and rated the procedure as more painful retrospectively. HSG patients tended to report a higher degree of information seeking. Information seeking was correlated with higher anxiety among HSG but not colposcopy patients. CONCLUSION(S) HSG is a highly stressful procedure associated with fear, anxiety, pain and information seeking. Research is needed to find possible ways of ameliorating these emotions and behaviors as they may have negative impact on patient cooperation.
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Affiliation(s)
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Liat Binyamin
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Arnon Wiznitzer
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
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Seshadri S, Khalil M, Osman A, Clough A, Jayaprakasan K, Khalaf Y. The evolving role of saline infusion sonography (SIS) in infertility. Eur J Obstet Gynecol Reprod Biol 2014; 185:66-73. [PMID: 25528732 DOI: 10.1016/j.ejogrb.2014.11.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 11/19/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022]
Abstract
Saline infusion sonography (SIS) has become a valuable diagnostic modality in gynaecology over the last three decades. SIS is now commonly employed for detailed evaluation of the uterine cavity as part of pre-treatment assessment in infertile women. The objective of this paper is review the scientific literature on SIS in infertility. Medline, Ovid and Cochrane databases were searched for relevant articles. The indications, technical aspects and the potential advantages of SIS are discussed. The efficacy and sensitivity of SIS are compared to hysteroscopy in the evaluation of uterine polyps, fibroids, intrauterine adhesions and uterine anomalies. Increasing evidence suggests the use of SIS prior to an in-vitro fertilization (IVF) cycle as it has increased sensitivity in the detection of intrauterine pathology. SIS is cost-effective and results in better patient satisfaction scores than hysteroscopy.
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Affiliation(s)
- S Seshadri
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom.
| | - M Khalil
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - A Osman
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - A Clough
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
| | - K Jayaprakasan
- Royal Derby Hospital, Derby & NURTURE, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Y Khalaf
- Assisted Conception Unit, Guys Hospital, 11th Floor, Tower Wing, Great Maze Pond, London SE1 9RT, United Kingdom
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Arnau B, Jovell E, Romero M, Gonzalez M, Esteba L, Garcia A. Lidocaine–prilocaine cream as analgesia for hysterosalpingography: a randomized, double blinded, controlled study. Eur J Obstet Gynecol Reprod Biol 2014; 182:216-9. [DOI: 10.1016/j.ejogrb.2014.09.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 11/30/2022]
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Kiykac Altinbas S, Dilbaz B, Zengin T, Kilic S, Cakir L, Sengul O, Dede S. Evaluation of pain during hysterosalpingography with the use of balloon catheter vs metal cannula. J OBSTET GYNAECOL 2014; 35:193-8. [PMID: 25141095 DOI: 10.3109/01443615.2014.948400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Our aim was to investigate the use of a balloon catheter device in comparison with metal cannula for hysterosalpingography (HSG) in terms of patient comfort. A total of 168 patients were randomised for HSG either with a balloon catheter (n = 83) or metal cannula (n = 85). Scores of pelvic pain during insertion of the devices, injection of the contrast medium and 1 h after the procedure were evaluated using the Wong Baker Faces Pain Rating Scale; complications and reinsertion rates were also noted. The pain scores were significantly lower in the balloon catheter group (p < 0.001). The reinsertion rate of metal cannula was higher (8.2% vs 2.4%) as well as the incidence of nausea being the most common short-term adverse effect (14.1% vs 1.2%) in the metal cannula group (p = 0.002). Performing HSG with a balloon catheter is advantageous for decreasing the pain and side-effects related to the procedure, when compared with the use of a metal cannula.
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Affiliation(s)
- S Kiykac Altinbas
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital
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