Abstract:

Objective: To evaluate the diagnostic value of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (RT-3D-HyCoSy) in assessing the contralateral tubal patency in patients after unilateral salpingectomy. Methods: A total of 66 patients of childbearing age with a history of unilateral salpingectomy and fertility needs who were treated in the gynecological outpatient department of Beijing Friendship Hospital from March 2018 to December 2021 were enrolled, and the contralateral fallopian tubes were examined by transvaginal RT-3D-HyCoSy. According to the patency of the fallopian tubes, the patients were divided into the patency group, the partial patency group and the obstruction group, and the pain scores of the three groups were compared. According to whether the contrast agent reflux occurred during the hysterosalpingo-contrast sonography, the patients were divided into the reflux group and the non-reflux group, and the endometrial thickness and fallopian tube obstruction rate were compared between the two groups. Results: Because of the obvious retroflexion of the uterus in one case, the hysterosalpingographic tube was stuck in the scar of the anterior wall of the uterus after cesarean section, and the catheterization was not successful, so the results of 65 cases were collected successfully. Transvaginal RT-3D-HyCoSy showed that 35 (53.8%) fallopian tubes were patent, 15 (23.1%) were partially patent, and 15 (23.1%) were obstructed. Myometrial contrast agent reflux occurred in 13 cases (20%), but not in 52 cases (80%). There was a statistically difference in the mean pain scores between the patency group, the partial patency group and the obstruction group (F=56.469, P<0.001), and the mean pain score in the obstruction group was greater than that in the partial patency group while this score in the partial patency group was greater than that in the patency group (all P<0.001). There was no significant difference in the mean endometrial thickness (t=0.163, P=0.872) and the rate of tubal obstruction ( χ²=3.385, P=0.066) between the groups with and without reflux. Conclusions: Transvaginal RT-3D-HyCoSy can better evaluate the patency of the contralateral fallopian tube in patients after unilateral salpingectomy, and the patients tolerate it well. This auxiliary examination provides an important reference for such patients to prevent the occurrence of recurrent ectopic pregnancy, and for doctors to decide whether the assisted reproduction treatment is suitable.

Key words: Hysterosalpingography, Imaging, three-dimensional, Salpingectomy, Fallopian tubes, Ultrasonography