Hysterosalpingography findings among women presenting for gynecological imaging in Ado-Ekiti, South western Nigeria

Authors

  • Olufunso S. Aduayi Department of Radiology, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
  • Ganiyu O. Akanbi Department of Radiology, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
  • Akinyemi A. Akintayo Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
  • Victor A. Aduayi Department of Epidemiology and Community Health, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20161688

Keywords:

Hysterosalpingography, Infertility, Tubal occlusion, Pain

Abstract

Background: Hysterosalpingography (HSG) is a valuable radiological procedure for imaging the female reproductive tract. This study highlights the spectrum of HSG findings among women presenting for gynaecological imaging in a tertiary health institution in Ado-Ekiti, South western Nigeria.

Methods: A prospective cross sectional study was conducted between October 2014 and September 2015. The study population consisted of 134 women presenting at the Radiology department with request forms for HSG. Pelvic ultrasonography was done using a 3.5MHz transducer prior to HSG. Imaging findings were documented, results were entered into a spread sheet and analysed using SPSS version 20. Chi square was used to determine association between tubal occlusion, age, type of infertility and previous history of surgery. Statistical significance was set at p-values <0.05.

Results: The age range of the study participants was between 23 to 50 years with a mean age of 34.9±5.53years. Age group 30-34 years (n=43, 32.1%) constituted a majority. Secondary infertility (n=84, 62.7%) was the most common clinical indication for HSG. The predominant relevant past surgical history was uterine evacuation (n= 41, 30.6%). Normal HSG findings were seen in 34 (25.4%) of the patients while others (n=100, 74.5%) had various abnormalities, the most common of which were tubal pathologies (n=89, 66.4%). There was a significant association between age and tubal occlusion (P=0.02).

Conclusions: HSG is still a relevant gynecological imaging modality in resource limited settings. Tubal occlusion was the most common abnormal HSG finding in this study. There is a need for continuous advocacy on preventive measures targeted at reducing the incidence of tubal pathologies among women in developing countries.

References

Bukar M, Mustapha Z, Takai U, Tahir A. Hysterosalpingographic findings in infertile women: A seven year review. Nigerian journal of clinical practice. 2011;14(2):168-70.

Miller JH, Weinberg RK, Canino NL, Klein NA, Soules MR. The pattern of infertility diagnoses in women of advanced reproductive age. American journal of obstetrics and gynecology. 1999;181(4):952-7.

Bello T. Pattern of tubal pathology in infertile women on hysterosalpingography in Ilorin, Nigeria. 2004.

Audu B, Massa A, Bukar M, El-Nafaty A, Sa'ad S. Prevalence of utero-tubal infertility. Journal of obstetrics and gynaecology. 2009;29(4):326-8.

Simpson Jr WL, Beitia LG, Mester J. Hysterosalpingography: A Reemerging Study 1. Radiographics. 2006;26(2):419-31.

Mol BW, Collins JA, Burrows EA, Van der Veen F, Bossuyt PM. Comparison of hysterosalpingography and laparoscopy in predicting fertility outcome. Human Reproduction. 1999;14(5):1237-42.

Brown SE, Coddington CC, Schnorr J, Toner JP, Gibbons W, Oehninger S. Evaluation of outpatient hysteroscopy, saline infusion hysterosonography, and hysterosalpingography in infertile women: a prospective, randomized study. Fertility and sterility. 2000;74(5):1029-34.

Pundir J, El Toukhy T. Uterine cavity assessment prior to IVF. Women's Health. 2010;6(6):841-8.

Akinola R, Akinola O, Fabamwo A. Infertility in women: Hysterosalpingographic assessment of the fallopian tubes in Lagos, Nigeria. Educational Research and Reviews. 2009;4(3):86.

Okafor C, Okafor C, Okpala O, Umeh E. The pattern of hysterosalpingographic findings in women being investigated for infertility in Nnewi, Nigeria. Nigerian journal of clinical practice. 2010;13(3).

Ibekwe P, Udensi M, Imo A. Hysterosalpingographic findings in patients with infertility in South eastern Nigeria. Nigerian Journal of Medicine. 2010;19(2).

Danfulani M, Mohammed MS, Ahmed SS, Haruna YG. Hysterosalphingographic findings in women with infertility in Sokoto North Western Nigeria. African Journal of Medical and Health Sciences. 2014;13(1):19.

Mgbor S. Pattern of Hysterosalpingographic findings in gynaecological patients in Enugu. Nig Med J. 2006;47:14-6.

Sinawat S, Pattamadilok J, Seejorn K. Tubal abnormalities in Thai infertile females. J Med Assoc Thai. 2005;88(6):723-7.

Hoffman L, Chan K, Smith B, Okolo S. The value of saline salpingosonography as a surrogate test of tubal patency in low-resource settings. International journal of fertility and women's medicine. 2004;50(3):135-9.

16. Adetiloye V. Hysterosalpingography in investigation of infertility: experience with 248 patients. West African journal of medicine. 1992;12(4):191-6.

Nwankwo N, Akani C. Pattern of hysterosalpingographic findings in infertility in Port harcourt. West African J Radio. 2005;12:15-9.

Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on the diagnostic categories of infertility. Human Reproduction. 2008;23(3):538-42.

Famurewa O, Adeyemi A, Ibitoye O, Ogunsemoyin O. Association between history of abdominopelvic surgery and tubal pathology. African health sciences. 2013;13(2):441-6.

Kiridi E, Ibrahim I, Lawani L. Hysterosalpingography: Still relevant in the evaluation of infertility in the Niger Delta. International Journal of Medicine and Biomedical Research. 2015;4(1):50-4.

Ronald G. The female reproductive systems in: Grainger RG, Allison DJ, editors. Diagnostic radiology.3:1809-69.

Khalaf Y. Tubal subfertility. Bmj. 2003;327(7415):610-3.

Idrisa A, Ojiyi E, Hamidu A. Hysterosalpingography versus Laparoscopy in the Evaluation of Female Infertility in Maiduguri, Nigeria. Tropical Journal of Obstetrics and Gynaecology. 2004;20(1):20-3.

Lavy Y, Lev-Sagie A, Holtzer H, Revel A, Hurwitz A. Should laparoscopy be a mandatory component of the infertility evaluation in infertile women with normal hysterosalpingogram or suspected unilateral distal tubal pathology? European Journal of Obstetrics and Gynecology and Reproductive Biology. 2004;114(1):64-8.

Downloads

Published

2017-01-05

Issue

Section

Original Research Articles