RADIOLOGICAL VERSUS SONOGRAPHIC HYSTEROSA LPINGOGRAPHY FOR EVALUATIONOF TUBAL PATENCY - PATIENT DISCOMFORT AND DIAGNOSTIC-ACCURACY OF HSG AND HYCOSY WITH ECHOVIST(R)200

Evaluation of tubal patency is usually assessed with hysterosalpingogr aphy (HSG) or laparoscopy including chromopertubation. Sonographical v isualisation with Echovist(R)200 (hysterosalpingo-contrast sonography - HyCoSy) provides a new noninvasive tool. Therefore we conducted a pr ospective controlled study to compare sonographic and radiological eva luation of the fallopian tube. Main test parameters were accuracy of b oth methods and patient discomfort. Patients and methods: 50 patients were enrolled in this study. All patients were examined by both techni ques; the sequence was randomly chosen. The results of HSG and HyCoSy were compared. Patient discomfort was assessed with a standardised que stionnaire using a visual analog scale (0-10). Results: Diagnosis of t ubal patency identifying proximal or distal blockage was the primary e nd point using HSG as standard technique. Proximal and distal patency by HSG was sonographically confirmed in 82.9% (63/76) and 82.1% (46/56 ) tubes respectively. If HSG revealed proximal or distal occlusion, id entical results were obtained in 91.7% (22/24) or 60% (12/20) by HyCoS y. No significant differences were found in patient discomfort. Howeve r a significant correlation was demonstrated between tubal patency and discomfort. The lowest score was obtained in patients with open tubes (4.6) increased in patients with distal occlusion (6.0) acid reached a maximum with proximal pathology (8.7). Conclusion: Compared to conve ntional HSG, HyCoSy provides a highly efficient evaluation of tubal pa thology and can be successfully used as a noninvasive screening method .