{"paper_id":"7a755997-b19c-41b4-88d7-21cd0df8584b","body_text":"Abstract\nPurpose\nTransvaginal hydrolaparoscopy (THL) is a mini-invasive technique, which allows exploration of the posterior pelvis. THL can be carried out as an office procedure and may replace hysterosalpingography and laparoscopy for the diagnosis of infertility. The aim of this study was to assess pain level during each step of THL.\nMethods\nForty infertile women underwent office THL with local anesthesia and had to score pain on a Likert scale (0—no pain, 5—maximum pain) during five stages of THL: stage 1, introduction of the intrauterine catheter; stage 2, introduction of the Veress needle in the Douglas pouch; stage 3, introduction of the trocar in the pelvis; stage 4, exploration of pelvic organs; stage 5, chromosalpingoscopy. At the end of the study, patients scored their overall satisfaction on a VAS scale (0—not satisfied at all; 10—completely satisfied).\nResults\nStage 5 was associated with the highest pain score in comparison with stages 1–4 (p < 0.001), while pain score during stage 4 was significantly higher in comparison with stages 1–3 (p = 0.001).\nConclusions\nOffice THL seems to be well tolerated by patients. Chromosalpingoscopy was the least tolerated stage but it does not adversely impact on the procedure, which can be adequately accomplished by performing proper counseling.\nSimilar content being viewed by others\nReferences\nDecker A (1944) Culdoscopy: a new method in diagnosis of pelvic disease. Am J Surg 64:40–44\nKelly JV, Rock J (1956) Culdoscopy for diagnosis in infertility. Am J Obstet Gynecol 76:523–537\nGordts SJ, Campo R, Rombauts L, Bronsens I (1998) Transvaginal hydrolaparoscopy as an outpatient procedure for infertility investigation. 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Arch Gynecol Obstet 287:155–159\nConflict of interest\nThe authors declare that they have no conflict of interest.\nEthical standard\nThe Study have been approved by the appropriate ethics committee and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.\nInformed consent\nAll persons gave their informed consent prior to their inclusion in the study.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nGiampaolino, P., Pellicano, M., Tommaselli, G.A. et al. In-office transvaginal hydrolaparoscopy: a step-by-step, intraoperative pain evaluation. Arch Gynecol Obstet 292, 1373–1377 (2015). https://doi.org/10.1007/s00404-015-3750-x\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-015-3750-x","source_license":"CC0","license_restricted":false}