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Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography.

Publication ,  Journal Article
Hurd, WW; Wyckoff, ET; Reynolds, DB; Amesse, LS; Gruber, JS; Horowitz, GM
Published in: Obstet Gynecol
June 2003

OBJECTIVE: Unilateral obstruction of the proximal fallopian tube is identified in 10-24% of patients undergoing hysterosalpingography for evaluation of infertility. Upon further testing, this obstruction spontaneously resolves 16-80% of the time. We hypothesized that patient rotation during hysterosalpingography might resolve proximal tubal obstruction in some cases by altering either the location of intrauterine air bubbles or the spatial relationship of the tube to the uterine fundus. METHODS: In patients in whom unilateral proximal tubal obstruction was detected during hysterosalpingography performed for standard clinical indications, the patient was rotated on her hip approximately 45 degrees such that the obstructed tube was first superior (ventral) to the patent tube, and dye was reinjected. If obstruction did not resolve, the patient was rotated in the opposite direction so that the obstructed tube was inferior (dorsal) to the patent tube and dye reinjected. RESULTS: Unilateral tubal obstruction was found in 15% of cases (24 of 156). Rotating the patient with obstructed tube superior to the patent tube never resulted in tubal patency, whereas rotating the patient with the obstructed tube inferior resulted in resolution of tubal patency in 63% of cases (15 of 24) CONCLUSION: . Unilateral cornual obstruction during hysterosalpingography is often resolved by rotating the patient such that the obstructed tube is more inferior. Although this observation may be the result of dislodging smaller air bubbles, from a fluid dynamics perspective a more likely explanation is unkinking of the more inferior tube.

Duke Scholars

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

June 2003

Volume

101

Issue

6

Start / End Page

1275 / 1278

Location

United States

Related Subject Headings

  • Rotation
  • Prospective Studies
  • Obstetrics & Reproductive Medicine
  • Hysterosalpingography
  • Humans
  • Female
  • Fallopian Tube Patency Tests
  • Fallopian Tube Diseases
  • Adult
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

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Hurd, W. W., Wyckoff, E. T., Reynolds, D. B., Amesse, L. S., Gruber, J. S., & Horowitz, G. M. (2003). Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography. Obstet Gynecol, 101(6), 1275–1278. https://doi.org/10.1016/s0029-7844(03)00361-2
Hurd, William W., Erich T. Wyckoff, David B. Reynolds, Lawrence S. Amesse, Jack S. Gruber, and Gary M. Horowitz. “Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography.Obstet Gynecol 101, no. 6 (June 2003): 1275–78. https://doi.org/10.1016/s0029-7844(03)00361-2.
Hurd WW, Wyckoff ET, Reynolds DB, Amesse LS, Gruber JS, Horowitz GM. Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography. Obstet Gynecol. 2003 Jun;101(6):1275–8.
Hurd, William W., et al. “Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography.Obstet Gynecol, vol. 101, no. 6, June 2003, pp. 1275–78. Pubmed, doi:10.1016/s0029-7844(03)00361-2.
Hurd WW, Wyckoff ET, Reynolds DB, Amesse LS, Gruber JS, Horowitz GM. Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography. Obstet Gynecol. 2003 Jun;101(6):1275–1278.
Journal cover image

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

June 2003

Volume

101

Issue

6

Start / End Page

1275 / 1278

Location

United States

Related Subject Headings

  • Rotation
  • Prospective Studies
  • Obstetrics & Reproductive Medicine
  • Hysterosalpingography
  • Humans
  • Female
  • Fallopian Tube Patency Tests
  • Fallopian Tube Diseases
  • Adult
  • 1114 Paediatrics and Reproductive Medicine