Concordance and contribution of hysterosalpingography and laparoscopy in tubal exploration in cases of infertility at the Ebolowa Regional Hospital Centre (ERHC)

Abstract

Introduction: The aim of our study was to evaluate the concordance between hysterosalpingography (HSG) and laparoscopy in the diagnosis of tubal lesions at the Ebolowa Regional Hospital Centre (CHRE).

Methodology: We conducted a descriptive cross-sectional study with an analytical component, at the CHRE from January 2022 to January 2025, including the records of patients who had undergone HSG showing a tubal lesion and benefited from operative laparoscopy for this diagnosis within 6 months. To assess concordance between the 2 procedures, the Kappa concordance coefficient (K) was used and the sensitivity and specificity, of HSG were calculated with a 95% confidence interval (CI) and a significance threshold of p<0.05.

Results: We included 140 cases. The mean age was 30.47 ± 4.86 years. A good agreement (k=0.67;95% CI 0.55-0.72) between hysterosalpingography and laparoscopy in the diagnosis of bilateral proximal tubal obstruction was found with good specificity (80.5%; CI 65.5-80.2) and sensitivity (87.5%; CI 75.5-90.2). Agreement between the 2 tests was was poor for bilateral distal tubal obstruction (K=0.32; 95% CI 0.25-0.43), and a discordance in the diagnosis of mixed tubal obstruction (K=0).

Conclusion: In the absence of technical and interpretation problems with HSG and laparoscopy, HSG can be a reliable examination in the diagnosis of certain tubal lesions such as bilateral proximal tubal obstruction.