To investigate the clinical value of selective salpingography (SSG) in proximal tubal obstruction (PTO).

A retrospective analysis was performed for the results of SSG examination in 257 cases of PTO diagnosed by hysterosalpingography (HSG) at Hebei Maternity Hospital from September 2021 to October 2022. Among them,there were a total of 373 fallopian tubes with proximal obstruction, 232 with bilateral PTO and 141 with unilateral PTO.All of them underwent further examined by SSG in our hospital.Whether the fallopian tubes were restored to patency after SSG and the morphological manifestations of the fallopian tubes after the restoration of patency were observed, and the manifestations after SSG were classified and compared. The patients were divided into the local hospital group and the erternal hospital group according to the different medical centers where HSG examinations were performed, and were divided into the unilateral group and the bilateral group according to the cumulative extent of lesions. The differences in the outcomes of PTO after SSG in different groups were observed and compared.

According to whether it was consistent with the preoperative diagnosis of HSG, whether patency was restored, and the morphology of the fallopian tubes after restoration of patency, the postoperative SSG manifestations of PTO patients were divided into three categories and six subtypes of A, B, C, D, E, and F. The three main categories of manifestations included obstructive, patency and incomplete obstruction, A, B, and C are obstructive types, D and E are patency types, and F are incomplete obstructive type. The obstruction type accounted for 25.20%, the patency type accounted for 64.61%, and the incomplete obstruction type accounted for 10.19%. The proportion of bilateral lesions with obstructive manifestations after SSG was higher than that of unilateral lesions, and the difference was statistically significant (P < 0.05). The postoperative outcomes of SSG varied between different medical scenters, and the probability of postoperative recovery was different,with statistically significant difference (P < 0.05).

The SSG has the dual role of tubal unclogging and HSG quality control, and its most important clinical significance is to clarify the localization and qualitative diagnosis of tubal obstruction.