Pain and side effects associated with 4-dimensional hysterosalpingo-contrast sonography for evaluating of the fallopian tubes patency

Figures & data

Figure 1. 4-dimensional HyCoSy using SonoVue: (a) Both the fallopian tube and uterus were clearly visible. (b) contrast agent ringlike diffusion (arrow) around the ovary (asterisks). (c) the fallopian tubes (triangle) located on the side of ovary (asterisks) and the fluid collection (round) was an indirect sign of tubal patency.

Table 1. Clinical qualities and the 4 D HyCoSy outcomes.

Characteristic	N (%)
Overall patients	818
Nulliparity	760 (92.9%)
Primary infertility	231 (28.2%)
Secondary infertility	587 (71.8%)
History of Dysmenorrhea	408 (49.9%)
Associated pelvic diseases
Myomas	42 (5.1%)
Pelvic endometriosis	8 (0.98%)
Uterine congenital malformations	26 (3.18%)
Endometrial polyps	14 (1.71%)
Tubal patency:
Bilateral patency	591 (72.3%)
Monolateral patency	96 (11.7%)
Bilateral occlusion	131 (16.0%)

Table 2. Pain perception and side effects.

Characteristic	N (%)
Mean overall VAS	4.9 ± 2.82 SD
Pain perception (T1):
Absent (VAS 0)	61 (7.5%)
Mild (VAS 1-4)	297 (36.3%)
Moderate (VAS 5-7)	287 (35.1%)
Severe (VAS 8-10)	173 (21.1%)
Pain perception (T2):
Absent (VAS 0)	485 (59.3%)
Mild (VAS 1-4)	293 (35.8%)
Moderate (VAS 5-7)	36 (4.4%)
Severe (VAS 8-10)	4 (0.5%)
Painkiller required	0 (0%)
Vaso-vagal reactions
Mild (nausea, sudation, bradycardia, hypotension)	18 (2.2%)
Severe (vomiting, confusion, syncope)	0 (0%)
Late Complications (haemorrhage, fever)	0 (0%)

Table 3. The pain perception in patients with different degrees of patency.

Pain perception	Tubal patency
	Bilateral patency	Monolateral patency	Bilateral occlusion	total
Absent	53	5	3	61
Mild	235	29	33	297
Moderate	253	10	24	287
Severe	50	52	71	173
total	591	96	131	818

Figure 2. 4 D HyCoSy process: (a) contrast agent was not injected in the beginning. (b) contrast agent was injected into the catheter and next entered in the uterus. (c) Lastly, contrast agent developed in the bilateral fallopian tubes.