Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

The objective was to evaluate the accuracy of hysterosalpingo-foam sonography using Lidocaine gel combined with power Doppler (HyLiFoSy-PD) in assessment of tubal patency compared to laparoscopic chromopertubationusing Methylene blue dye tubal patency test as the gold standard. Methods: Cases of unexplained or suspected tubal factor infertility were assessed for tubal patency. Patients were examined postmenstrually by transvaginal ultrasound followed by introduction of a pediatric Foley{u2019}s balloon catheter through the cervix into the uterus. The foam was prepared combining about 3{u2013}4mL of 2% lidocaine gel & 12{u2013}13mL of saline. The foam was introduced into the uterine cavity while evaluating the flow of contrast medium in each tube, using greyscale and power Doppler imaging to detect the flaming sign. The tubes were considered patent if the flow of foam was seen throughout the whole length of tube in addition to peritoneal spill, blocked if no cornual flow was seen. This was followed by standard laparoscopyand Methylene blue dye tubal patency test (within 2 days). Laparoscopy performers were blinded to the ultrasound findings. Results: 122 ladies were included in our study, the procedure was cancelled in 7 (5.8%) of them due to various reasons Mean age was 27.4 years +/- 4.7 standard deviation (SD), mean Body Mass Index (BMI) 29.5 kg/m2 +/- 2.1 SD, mean duration of the procedure was 10.74 minutes +/- 2 SD Analysis of pain perceived using verbal rating scale of pain, showed the procedure to cause minimal pain in 74.6% of the subjects, moderate pain in19.67% and severe pain in 5.8%and procedure had to stop No complications were reported.(207) tubes were patent by HyFoSy versus (210) tubes by laparoscopy

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