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The learning curve of selective salpingography and tubal catheterization
Spyros Papaioannou1, Masood Afnan, Alan J Girling
1Assisted Conception Unit, Birmingham Women's Hospital, Birmingham, United Kingdom. spyrospap@talk21.com
Objective:
To determine the effect of increasing experience in fluoroscopically guided selective salpingography and tubal catheterization on radiation doses and screening times, thus establishing a learning curve for the procedure.
Design:
Retrospective case note analysis.
Setting:
IVF center of an academic teaching hospital.
Patients:
Three hundred sixty-six patients with infertility seen over 3.5 years.
Intervention(S):
Fluoroscopically guided selective salpingography and tubal catheterization.
Main Outcome Measure(S):
Reductions in radiation doses and screening times for different categories of selective salpingography and tubal catheterization, expressed as percentage reductions during the study period and reductions per 10 procedures.
Result(S):
During the study period, The median dose of radiation decreased by 62.6%-71.9%, and the median screening time declined by 61.5%-78.5%. Reductions per 10 procedures were 2.5%-4.2% and 2.7%-5%, respectively.
Conclusion(S):
Significant reductions in radiation doses and screening times start early in a clinical team's practice of selective salpingography and tubal catheterization and continue even as trainees are added to the pool of operators.