Efficacy of hysterosalpingography in evaluating tubal and peritubal disease in 200 patients with infertility

The hysterosalpingographic findings of tubal and peritubal disease were correlated with laparoscopic findings in 200 women evaluated for infertility. Radiographic signs included tubal dilation, blockage, salpingitis isthmica nodosa, and ''clumping,'' defined as poor delineation and crowding of the ampullary portion. Radiographic sensitivity and specificity were 82% and 75%, respectively. Excluding ''clumping'' as a sign of peritubal disease increased specificity to 91% but decreased sensitivity to 73%. The sensitivity of hysterosalpingography was 93% for tubal blockage and 82% for peritubal adhesion with or without blockage. Salpingitis isthmica nodosa was associated with peritubal adhesions and/or blockage laparoscopically