Transvaginal salpingosonography for assessing tubal patency in women previously treated for pelvic inflammatory disease and benign ovarian tumors

Objective The aim of this study was to evaluate the role of transvaginal sa lpingosonography in the assessment of tubal patency among women previously treated conservatively for pelvic inflammatory disease and surgically for a benign ovarian tumor. Design Twenty-two women were recruited for this study at the University Hos pital of Oulu. Transvaginal salpingosonography was scheduled to be performe d twice within a 3-month interval. X-ray hysterosalpingography was chosen a s a reference method and was performed within 2 days of the second salpingo sonography examination during the same menstrual cycle. Altogether, 31 Fall opian tubes were assessed with the second salpingosonography examination an d X-ray hysterosalpingography. Results Twenty-nine Fallopian tubes were observed by both methods to be pat ent (i.e. 29 tubes by each method, brit not necessarily the sal-ne tubes). An occlusion was diagnosed by each method in two tubes only, of which one a ppeared occluded by both methods, while one tube from each method appearing to be occluded was demonstrated to be patent using the other method. The a greement of transvaginal salpingosonography compared with X-ray hysterosalp ingography was 94%, the sensitivity 50%, the specificity 97%, the positive predictive value 50% and the negative predictive value 97%. Two successive transvaginal salpingosonography examinations were performed in 18 patients with 27 Fallopian tubes. Disagreement was observed for only one tube. The a greement between these two examinations was 96%, the sensitivity 100%, the specificity 96%, the positive predictive value 67% and the negative predict ive value 100%. The kappa coefficient was 0.78 (95% confidence interval 0.7 5-0.81). Conclusions In conclusion, transvaginal salpingosonography can be used in p atients with previous pelvic inflammatory disease and adnexal surgery due t o its ease of use, reliability and low costs on an out-patient basis. Among these patients, tubal patency was a common finding.