Prise en charge des obstructions tubaires proximales par l'hydrotubation en Centrafrique

Objectifs : Évaluer la prise en charge des obstructions tubaires proximales bilatérales par l'hydrotubationMatériels et méthodes : étude transversale analytique réalisée au Centre Hospitalier et Universitaire Maman Elisabeth en Centrafrique entre le 2 janvier 2015 et le 31 mars 2017. Les obstructions tubaires bilatérales proximales (OTBP) décelées à l'hystérosalpingographie ont subi une hydrotubation en vue de leur ré perméabilisation.Résultats: soixante-treize patientes avec des obstructions tubaires bilatérales proximales ont été retenues. Elles avaient un âge moyen de 32,9 ±5,9 ans avec les extrêmes de 20 à 42 ans. Après trois séances d'hydrotubation, 39 cas d'OTBP (53,4%) ont persisté à l'hystérosalpingographie de contrôle et 34 patientes (46,6%) ont présenté une perméabilité tubaire. Les trompes étaient perméables beaucoup plus chez les patientes de 20 à 29 ans que les patientes de 30 à 42 ans. Il existe un lien significatif entre l'âge et la ré perméabilisation après hydrotubation P=0,0002). Les jeunes avaient présenté un taux de ré perméabilisation tubaire significativement élevé que les moins jeunes après l'hydrotubation. Cependant il est difficile d'attribuer la perméabilité tubaire à l'efficacité de l'hydrotubation.Conclusion : En situation de ressources limitées l'hydrotubation peut contribuer à la ré perméabilisation des trompes chez des patientes présentant des obstructions proximales bilatérales surtout chez les sujets jeunes

Pratique de l'hysterosalpingographie a l'hopital regional de Ngaoundere

OBJECTIFS:Decrire la pratique et les resultats de l'HSG dans le Service d'Imagerie Medicale de l'Hopital regional de N'Gaoundere.MeTHODES: Il s'agit d'une etude transversale descriptive. Les donnees ont ete collectees de janvier a decembre 2012 au travers d'un questionnaire. Les 120 hysterosalpingographies effectuees durant la periode d'etude ont ete incluses. Elles representaient 72;8 des examens radiologiques specialises et 3 de toutes les radiographies. L'age moyen des patientes etait de 33 ans. Les patientes avec une gestite de 0 a 1 representaient 80;5 et celles avec une parite de 0 a 1 representaient 90. Les antecedents etaient domines par les infections genitales (75); puis les avortements spontanes (10) et les avortements provoques (8). ReSULTATS L'indication principale de l'HSG etait l'infertilite (67;50); suivie du bilan tubaire apres myomectomie (16;90); des avortements a repetition (5;83); de la pelvialgie chronique (5) et des metrorragies (5). Le produit de contraste utilise etait iode hydrosoluble; et le volume moyen administre etait de 22 ml. En moyenne; six cliches ont ete realises par patiente. Dans 65;83 aucun effet indesirable n'a ete observe. Les effets indesirables observes etaient la douleur (26;3); l'hemorragie (5;30) et le malaise vagal (2;6). 89;47 des HSG avaient une lesion. Les pathologies observees etaient les obstructions tubaires (36; 66); les malformations uterines (12;5); les hydrosalpinx (8;35); les suspicions de myome (6;70); les beances du col (5;83); les synechies uterines (5;83) et les adherences peritoneales (5;83). CONCLUSION L'HSG est l'examen radiologique specialise le plus pratique dans le bilan de l'infertilite feminine a Ngaoundere. Ses resultats sont comparables aux autres series africaines. La douleur est le principal effet indesirable

The Pattern of Hysterosalpingographic Findings in Women Being Investigated for Infertility in Nnewi; Nigeria

Background: Tubal occlusion is the commonest cause of female infertility in the developing societies. Hysterosalpingography remains a vital method of assessing tubal patency especially in resource limited settings such as ours. Objective: To review the pattern of hysterosalpingographic findings among women being investigated for infertility in Nnamdi Azikiwe University Teaching Hospital Nnewi; Nigeria over a period of five years (2001- 2005). Method: The data obtained from the request forms and radiologists' reports were analyzed using SPSS version 11. The level of statistical significance was set at p

Hysterosalpingographic Findings in Patients with Infertility in South Eastern Nigeria

Background:Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in moderngynecological practice; especially in developing countries. The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital;Abakaliki; Southeastern Nigeria. A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data; and cervical; uterine and tubal; pathology. Results: The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80of patients (primary infertility 20and secondary infertility 60). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. Conclusion:Tubal blockage and tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections; mismanaged pregnancies and septic abortions; as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted

Hysterosalpingographic Findings in Patients with Infertility in South Eastern Nigeria

Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in modern gynecological practice; especially in developing countries.The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital;Abakaliki; Southeastern Nigeria. A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data; and cervical; uterine and tubal; pathology.The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80of patients(primary infertility 20and secondary infertility 60). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. Tubal blockage and tubal factor infertility are still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections; mismanaged pregnancies and septic abortions; as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted

Impact of demographic and psychosocial factors on hysterosalpingography pain and discomfort

Background: Hysterosalpingography (HSG) is an important diagnostic procedure in the investigation of infertility. It is the radiographic delineation of uterine and tubal cavities and is part of the diagnostic evaluation of conjugal infertility.1 This diagnostic procedure is associated with high levels of anxiety, pain and stress from various causes. This study was designed to investigate the impact of demographic and psychosocial factors on HSG pain and discomfort. Method: One hundred hysterosalpingography referrals were recruited for this study. Verbal detector scales were used to assess pain perception, Likert scales were used to assess the psychosocial variables, while visual analogue scales were used to assess discomfort. Pearson's correlations were conducted. Tests were two-tailed, with p < 0.05 indicating statistical significance. Results: Some of the patients (34%) indicated that the administration of analgesics prior to the procedure reduced the pain and discomfort associated with the procedure. Mean ± standard deviation of pain and discomfort were 2.82 ± 0.77 and 6.36 ± 2.19 respectively. Age correlated signifi cantly with pain perception (r = -0.22, P < 0.05), while pain correlated signifi cantly with perception of discomfort(r = -0.46, P < 0.05). Conclusion: Age signifi cantly correlated with pain. This is a factor that could be harnessed for clinical use

Aspects radiologiques de la pathologie utero-tubaire dans la sterilite feminine: a propos de 1314 hysterosalpingographies au CHU-Lome

1314 examens hysterosalpingographiques ont ete realises chez des femmes consultant pour sterilite secondaire et 25 pour cent une sterilite primaire. Les anomalies radiologiques observees sont dominees par les lesions uterines (53 pour cent) dont pres de la moitie representee par les sequelles traumatiques (27 pour cent). Les osbtructions tubaires representent 30 pour cent. 17 pour cent des femmes ont une hysterosalpingographie normale. La proportion elevee des sterilites secondaires; des lesions traumatiques uterines et des obstructions tubaires traduit la necessite de mettre en place des programmes de sante publique visant a sauvegarder la fecondite de la femme bien que les experts demographes parlent de l'Afrique en terme d'explosion demographique et de limitation des naissances

Les lesions tubaires et peritoneales a la coelioscopie chez les femmes steriles aux Cliniques Universitaires de Kinshasa

Les 434 cas de coelioscopie diagnostique pour sterilite pratiquee aux Cliniques Universitaires de Kinshasa du 1er Aout 1988 au 31 juillet 1992 font l'objet d'une etude retrospective pour apprecier l'importance des differentes lesions tubo-peritoneales et leurs etiologies. Les obstructions tubaires distales sont deux fois et demi plus frequentes que les obstructions tubaires (OT) proximales; qui predominent chez les epouses des polygames. Les Obstructions tubaires distales et les adherences pelviennes sont plus frequentes chez les femmes avec antecedents de chirurgie gynecologique pelvienne. La frequence des cas d'endometriose pelvienne est de 6;4 pour cent. A part les maladies sexuellement transmissibles qui sont souvent evoquees comme cause; la chirurgie pelvienne semble etre egalement a la base de ces lesions

A comparative study of hysterosalpingography and laparoscopy in the investigation of infertility

A comparison of Hysterosalpingography (HSG) with Laparoscopy in the evaluation of tubal factor in 105 infertile women is presented. Results of these tests showed agreement for tubal patency in 65.7 per cent of the cases. Both procedures are discussed with their limitations