Association between history of abdominopelvic surgery and tubal pathology.

BACKGROUND Pelvic infection, unsafe abortion and previous laparatomy are risk factors for tubal infertility among Nigerian women. Reports on the relationship between these factors and tubal pathology seen on hysterosalpingography (HSG) from our environment have been few. OBJECTIVE To assess the prevalence of tubal occlusions among patients referred for HSG and examine the association between previous history of abdominopelvic surgery (including dilatation and curettage for abortion) and tubal occlusion. METHODS We studied one hundred and thirty women referred to the Radiology department for HSG because of infertility. HSG was performed during the early proliferative phase of the menstrual cycle. Information about type and duration of infertility, history of abdomino -pelvic surgery and history suggestive of previous pelvic infection, were obtained from the patients. The data obtained were analyzed using SPSS version 11. Test of association using the chi-square test was done where appropriate and differences were considered at p= 0.05. RESULTS Sixty one women had bilaterally patent tubes; tubal pathology was seen in sixty nine women. Significant association exits between tubal pathology and history of pelvic surgery p=0.01, pelvic infection p=0.02 and duration of infertility p=0.04. CONCLUSION Previous surgery especially dilation and curettage, PID duration and type of infertility are associated with tubal pathology among Nigerian women. Creative methods of lowering the cost of diagnosis and management of tubal occlusion need to be instituted.