LAUSR

OBJECTIVE To assess the diagnostic accuracy of hysteroscopy compared to laparoscopic chromopertubation for the detection of fallopian tubal obstruction. DATA SOURCES An electronic search from inception to March 31, 2020 was performed in Medline, Scopus, EMBASE and the Cochrane Controlled Trials Register. METHODS OF STUDY SELECTION This diagnostic accuracy meta-analysis was conducted following PRISMA and SEDATE recommendations. A combination of the following MeSH terms and keywords was included in search strategy: "hysteroscopy[MeSH]", "tubal obstruction" "tubal patency", "tubal dysfunction", "tubal blockage". Quality assessment of included studies was conducted using the QUADAS-2 tool. Publication bias was evaluated by means of Deek funnel plot asymmetry test. The following outcomes were analyzed: diagnostic odds ratio (DOR), area under hierarchical summary receiver operating characteristic (HSROC) and area under receiver operating characteristic curve (AUROC), sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR). TABULATION, INTEGRATION, AND RESULTS Six studies comparing hysteroscopy with laparoscopic chromopertubation were included in the meta-analysis. After pooling of all the studies, DOR was 43. Evaluated AUROC was 0.93, correlating with high diagnostic accuracy for the index test. Sensitivity and specificity were 88% and 85% respectively. Also, PLR and NLR were 5.88 and 0.16 respectively. CONCLUSION Hysteroscopic techniques are highly accurate and sensitive for detecting fallopian tubal obstruction. Interventional assessment enhances diagnostic accuracy relative to observational assessment as does the office setting relative to the operating room. Additional studies, along with refinement of the techniques, could facilitate the widespread use of hysteroscopic techniques for the detection of fallopian tube occlusion. PROSPERO REGISTRATION CRD42020159973.