Fertility and sterility · 2017
Performing the Parryscope technique gently for office tubal patency assessment.
Клиническое исследованиеСтатьяVideo-Audio MediaНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Parry J Preston, Riche Daniel, Rushing John, Linton Brittany, Butler Vicki, Lindheim Steven R
Аннотация
OBJECTIVE: To demonstrate a novel approach to office tubal patency assessment through infusing air into saline during flexible office hysteroscopy. We also provide data addressing pain and patient experience relative to hysterosalpingography (HSG).
DESIGN: Video presentation of clinical technique with supportive crossover data (Canadian Task Force classification II-1). Its University of Mississippi Medical Center Institutional Review Board protocol number is 2013-0230.
SETTING: Academic hospital.
PATIENT(S): Women undergoing office hysteroscopy and ultrasound, with a subset also having HSG.
INTERVENTION(S): Air infusion into saline during office hysteroscopy.
MAIN OUTCOME MEASURE(S): The focus is on demonstrating how the technique appears and is performed, with supplemental Likert data addressing subjective pain and preference relative to HSG.
RESULT(S): When performed as described, this office technique has 98.3%-100% sensitivity to tubal occlusion and 83.7% specificity. The gentle technique is central to accurate outcomes, which is facilitated through use of a small-caliber (<3 mm), flexible hysteroscope and avoiding uterine overdistention. Patients are far more likely to report maximum discomfort with HSG. Among patients who also had HSG, 92% somewhat or strongly prefer hysteroscopic assessment. Also, 96% of patients reporting maximum discomfort with HSG had mild to no discomfort with the described technique.
CONCLUSION(S): Air-infused saline at flexible office hysteroscopy can accurately, gently, and rapidly assess tubal patency. Coupled with strong patient preference for this technique over HSG, it is a promising option for evaluating fertility.
CLINICAL TRAIL REGISTRATION NUMBER: NCT02005263.
DESIGN: Video presentation of clinical technique with supportive crossover data (Canadian Task Force classification II-1). Its University of Mississippi Medical Center Institutional Review Board protocol number is 2013-0230.
SETTING: Academic hospital.
PATIENT(S): Women undergoing office hysteroscopy and ultrasound, with a subset also having HSG.
INTERVENTION(S): Air infusion into saline during office hysteroscopy.
MAIN OUTCOME MEASURE(S): The focus is on demonstrating how the technique appears and is performed, with supplemental Likert data addressing subjective pain and preference relative to HSG.
RESULT(S): When performed as described, this office technique has 98.3%-100% sensitivity to tubal occlusion and 83.7% specificity. The gentle technique is central to accurate outcomes, which is facilitated through use of a small-caliber (<3 mm), flexible hysteroscope and avoiding uterine overdistention. Patients are far more likely to report maximum discomfort with HSG. Among patients who also had HSG, 92% somewhat or strongly prefer hysteroscopic assessment. Also, 96% of patients reporting maximum discomfort with HSG had mild to no discomfort with the described technique.
CONCLUSION(S): Air-infused saline at flexible office hysteroscopy can accurately, gently, and rapidly assess tubal patency. Coupled with strong patient preference for this technique over HSG, it is a promising option for evaluating fertility.
CLINICAL TRAIL REGISTRATION NUMBER: NCT02005263.