Re: U/S contrast agent use for tubal pat
From: James S Smeltzer MD (gaperina@mindspring.com)
Tue Aug 4 09:00:21 1998
Nancy,
Are there data to indicate an improved fertility in 3 mos after procedure?
Jim S
At 12:27 AM 8/4/1998 -0500, you wrote:
>I had the opportunity to be involved in the clinical trials for the use of
>Albunex in evaluation of fallopian tube patency.( Albunex is a human serum
>albumin encapsulated microbubble contrast agent distributed by Mallinckrodt)
>
>The benefit of its use over simple negative contrast (saline) is that each
>tube can be evaluated individually without the use of color doppler. Saline
>in the peritoneal cavity after instillation through the cervix indicates
tubal
>patency but is nonspecific for individual tube.
>
>Some of the benefits of sonoHSG over radiographic HSG are as follows:
>- no ionizing radiation
>- no iodinated contrast media
>- better absorption of contrast in the peritoneum
>- increased specificity/sensitivity in endometrial cavity evaluation
>- additional info provided by sono re: myometrium; ovaries; etc.
>- can be performed anywhere that endovaginal u/s is performed.
>- greater overall acceptance by patients( in my experience...)
>
>Problem with U/S method:
>- Lack of experienced practitioners
>
>Like most new techniques, it takes some time to become accustomed to the
>procedure and to become comfortable with the subsequent results.
>
>Most comments in the literature and anecdotally, that I have encountered,
>agree that it is a good first line diagnostic procedure. I do not think
that
>the number of HSGs is going to drop dramatically any time soon, and
>laparoscopy, not radiographic HSG, is still the gold standard.
>
>Dr. Anna Parsons from Tampa Fl. has been a prolific writer re:
>sonohysterography and sonosalpingography. Check her out if interested.
>
>Hope this helps. Feel free to contact me directly if I can be of service...
>Nancy A. Spangler, RDMS
>spnglr@aol.com
>
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