A second hysterosalpingography reduces the use of selective technique for treatment of a proximal tubal obstruction.

OBJECTIVE

To assess whether a second hysterosalpingography (HSG) can permit tubal patency, reducing the use of selective salpingography in patients with proximal tubal obstruction.

DESIGN

Prospective study.

SETTING

University hospital.

PATIENT(S): The study population consisted of 360 infertile women.

INTERVENTION(S): In patients with unilateral or bilateral proximal tubal obstruction, a second HSG was performed after about 1 month. In those cases with persistent obstruction, an immediate selective salpingography and tubal catheterization were performed.

MAIN OUTCOME MEASURE(S): Tubal opacification.

RESULT(S): Forty patients underwent a second HSG procedure for proximal tubal occlusion. Among these, 24 achieved bilateral tubal patency. Thus, repetition of a conventional HSG after 1 month avoided unnecessary salpingography in 60% of patients.

CONCLUSION(S): In infertile women with proximal tubal obstruction, we believe it is best to perform a second HSG. HSG is easy to carry out and subjects patients to a lower dosage of radiation and fewer risks than selective salpingography. The latter technique should be reserved for unsuccessful cases.