Concordance Between Hysterosalpingography and Laparoscopy in the Investigation of Female Infertility: A Prospective Study of 131 Patients at the Nouar Fadela Specialized Hospital in Oran
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Abstract
Objective: To evaluate the diagnostic value and degree of concordance between hysterosalpingography (HSG) and laparoscopy in the exploration of the tuboperitoneal factor in women suffering from infertility.
Materials and Methods: A prospective study was conducted at the Nouar Fadela Specialized Hospital in Oran, including 131 infertile patients over two years from March 2022 to July 2024. All patients underwent preoperative hysterosalpingography (HSG) followed by diagnostic and surgical laparoscopy with methylene blue staining (gold standard). Tubal patency, phimosis, and pelvic adhesions were analyzed. Concordance was assessed using Cohen’s kappa coefficient.
Results: Hysterosalpingography (HSG) has shown good sensitivity for overall tubal patency, but limited specificity in detecting peritoneal adhesions and fine fimbriae. Laparoscopy corrected the diagnosis in a significant number of cases, revealing periapical adhesions not suspected on HSG (HSG false negatives) and resolving false diagnoses of proximal tubal obstruction related to tubal spasms (HSG false positives).
Conclusion: While hysterosalpingography (HSG) remains the first-line examination for evaluating the uterine cavity and tubal lumen, laparoscopy remains irreplaceable as the gold standard. It allows for a precise diagnosis of peritoneal lesions and offers the advantage of immediate surgical treatment.
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