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Article Abstract

Objective: This study investigated the therapeutic effect of 4-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) combined with hydrotubation in the treatment of tubal obstruction and the risk factors affecting treatment outcomes.

Methods: Data of 700 fallopian tubes which underwent 4D-HyCoSy at the Fourth Affiliated Hospital of Harbin Medical University from Jul 2018 to Dec 2024 were retrospectively analysed. Subjects (408 fallopian tubes) were the fallopian tubes which were diagnosed with tubal obstruction. They were divided into 2 groups, namely an experimental group, in which triple anti-inflammatory medication was injected after 4D-HyCoSy, and a control group, in which the same dose of saline was injected following 4D-HyCoSy. 4D-HyCoSy was performed again after 1 month. The treatment outcomes between the 2 groups were compared and analysed. Univariate and multivariate logistic regression analyses were performed on the clinical data and the 4D-HyCoSy imaging data in the experimental group.

Results: (1) Post-therapeutic tubal patency: 11.27% of the tubes in the experimental group were diagnosed as tubal patency post-therapeutically, while 87.25% were diagnosed as tubal obstruction . The level of tubal patency of the experimental group was higher than that of the control group (p< 0.05). (2) Therapeutic effect in tubal obstruction: The total effective rate of the experimental group was 27.94%. The therapeutic effect in the experimental group was higher than that in the control group (p< 0.05). (3) Differences in pre-therapeutic tubal visualization and peri-ovarian contrast media diffusion had a significant effect, and were independent risk factors affecting the therapeutic effect of the combined therapy of 4D-HyCoSy and hydrotubation (p< 0.05).

Conclusions: (1) The combination of 4D-HyCoSy and hydrotubation for the treatment of tubal obstruction unblocked the fallopian tubes with a remarkable therapeutic effect. (2) Pre-therapeutic tubal visualization and peri-ovarian contrast media diffusion are independent risk factors closely related to treatment outcomes.

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http://dx.doi.org/10.1016/j.ultrasmedbio.2025.08.011DOI Listing

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