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. (C)2000 by American Society for Reproductive Medicine.
Dessole, S., Meloni, G. B., Capobianco, G., Manzoni, M. A., Ambrosini, G., & Canalis, G. C. (2000). A second hysterosalpingography reduces the use of selective technique for treatment of a proximal tubal obstruction. Fertility and Sterility, 73(5), 1037–1039. https://doi.org/10.1016/S0015-0282(00)00415-5