Re: CAN WE BE HONEST ABOUT HYSTEROSONOGRAPH RESULTS?
From: Rafael Haciski MD (haciski@earthlink.net)
Wed Mar 28 21:30:48 2001
Like you, I do all my own hysterosalpingograms, and sonohysterography.
As with all other clinical tests, the results must be placed in their proper
context - the test results may be of little value on their own, and if not
properly assimilated into the whole diagnostic picture, may indeed be
misleading.
The bottom line is that clinical acumen is still important, no matter what
tests we utilize.
--
Rafael Haciski, MD FACOG
Gynecology & Infertility Assoc.
Baltimore MD
http://www.ivf-md.com
> From: dr_naseemahmad@yahoo.com (Dr.Naseem Ahmad)
> Reply-To: ob-gyn-l@obgyn.net
> Date: Tue, 27 Mar 2001 08:47:24 -0600
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
> Subject: CAN WE BE HONEST ABOUT HYSTEROSONOGRAPH RESULTS?
>
> Dear Sonologists, please dont get upset if I try to call a spade a
> spade! The problem is, especially in my part of the world that if you
> express your unbiased opinion about any medical issue the relevant
> people tend to oppose it no matter what.I am a gynaecologist and have
> special interest in Infertility. Being a male gynaecologist in a
> country where male gunaecologists are deemed odd and 'out of bounds'
> unless the patient is driven to them in search of better management. I
> think I am the only gynaecologist in the world who performs his own
> hysterograms and these number more than 10000!This vast personal
> experience has educated me immensely and because of my personal
> intervention let me say very modestly that hundreds of patients who were
> wrongly diagnosed and were therefore being treated differently were put
> on the right track and successfully conceived .Briefly ,being very much
> involved in this diagnostic modality I have very carefully, logically
> and tactfully observed and compared the results of hycosy which is
> getting popular recently in my city. The sonologists are over the moon
> and a lot of patients are going thru this test. Sadly a lot of my
> patients whom I subjected to conventional hysterograms without any
> financial damageto them were wrongly diagnosed by the hycosy even though
> they were tested by otherwise very competent sonologists. I believe
> that any diagnostic test if proved inconclusive is not worth the bother
> no matter how many theoretical plus points may have been enumerated in
> its favour. I have very hot debates with the representatives of a
> company who are intensively promoting the use of hycosy. I feel in my
> part of the world no matter how discrete the attending physicians may be
> there is a very good chance that the test is likely to fall into wrong
> hands causing damage sometimes irreversible to the patients as far as
> the fertility potential is concerned. Every sonologist cant be as good
> as Campbell or Dubose Terry and every machine cant be what it should be
> like hence the ultimate diagnosis is bound to be unreliabel. Also even
> if the test is carried out correctly the picture on which the referring
> gynaecologist is going to depend on is least likely to unveil the actual
> pathology. I can go on for ever but for the time being this may be
> sufficient to generate realistic and HONEST opinions. Sorry for this
> long letter. Naseem Ahmad FRCOG
>
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