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CAN WE BE HONEST ABOUT HYSTEROSONOGRAPH RESULTS?From: Dr.Naseem Ahmad (dr_naseemahmad@yahoo.com)Mon Mar 26 10:33:58 2001
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 damage to them were wrongly diagnosed by the hycosy even though they were tested by otherwise very competent sonologists. I believe that ant 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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