3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women.
Objectives: This study was aimed to assess the use of three-dimensional hysterosalpingocontrast sonography (3D-HyCoSy) as a routine tool for evaluating infertile women in the office. Methods: In 25 non-selected infertile patients, tubal patency and uterine cavity were investigated by 3D-HyCoSy with saline as a contrast medium. The efficacy of the procedure was evaluated with X-ray hysterosalpingography (XHSG) as reference.Results: The positive predictive value, negative predictive value, sensitivity and specificity of predicting tubal patency by 3D-HyCoSy were 100, 33.3, 84.4 and 100%, respectively. The full contour of uterine cavity was depicted in 96% of cases by 3D-HyCoSy and 64% by XHSG (P < 0.005). The uterine cavity area measured on 3D-HyCoSy correlated well with the volume of contrast media required on XHSG (R 2 ¼ 0.8166). Conclusion: 3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women. S T A G 0 6 : F E T A L T H E R A P Y STAG-02Impact of sonohysterography on the management of women with uterine myomas D. H. Pretorius, E. Becker & A. S. Lev-ToaffPurpose: Assess the importance of sonohysterography findings in women with suspected/known myomas particularly with regard to location within/near the endometrial cavity and its impact on treatment. Methods: Review of 240 sonohysterograms identified 109 women (age 24-76, mean 42.4; 84.4% pre-menopausal, 15.6% post-menopausal) with suspected/known myomas. Images, reports, pathology/ surgery results, and clinical/imaging follow up were reviewed. Myoma location with respect to the cavity was described and feasibility of hysteroscopic resection assessed. Results: Indications for sonohysterography abnormal bleeding (74.3%), infertility (8.3%), other (17.4%). Five groups were defined (1) normal cavity (19/109 patients, 17.4%); (2) normal but displaced cavity (7/109, 6.4%); (3) myoma with endoluminal component (50/ 109, 45.9%); (4) other endoluminal findings, mostly polyps (25/109, 22.9%); (5) myoma plus other (8/109, 7.3%). An intracavitary myoma(s) (ICM), a submucous myoma >50% within the cavity, was found in 45 patients; submucous -20; mural -71; and subserosal -37 (57 patients had myomas in more than one location). SHG indicated that myomas were amenable to hysteroscopic resection (HR) in 45 women; in 39 others SHG revealed that myoma(s) were not amenable to HR. There was a significant difference in the use of hysteroscopic resection between these two groups; HR was performed in 21/45 (46.7%) of the former but only in 2/39 (5.1%) of the latter (P < 0.01). Other treatments were not significantly different between the two groups: hysterectomy in 7/45(1...
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