Transvaginal hydrolaparoscopy compared with laparoscopy for the evaluation of infertile women: a prospective comparative blind study
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Abstract
Standard diagnostic laparoscopy is considered the gold standard to investigate tubo-peritoneal infertility. It requires general anaesthesia and full operative facilities. Due to the risk of complications, laparoscopy is frequently postponed to the final stage of infertility evaluation or even after treatment trials have failed. Transvaginal hydrolaparoscopy (THL) is based on vaginal access using a needle puncture technique and saline for distention. THL can be performed on an outpatient basis under local anaesthesia. However, little data exist concerning the accuracy of THL in comparison with laparoscopy. We conducted a prospective comparative blind trial to assess the feasibility and accuracy of THL compared with diagnostic laparoscopy in infertile women. Sixty women were assigned to undergo THL immediately prior to laparoscopy. Different operators evaluated the findings of the two procedures. In order to evaluate the accuracy of THL, findings in terms of tubal pathology, endometriosis and adhesions were analysed. The success rate of accessing the pouch of Douglas was 90.2%. Complication rate was 1.6%. THL diagnosis was correlated with that of laparoscopy in 92.3% of cases. In cases of abnormal findings by THL, there were no normal laparoscopies. Our pilot study suggests that THL is a safe and reproducible method. Retroverted uterus should be considered as a relative contraindication to THL. When a complete evaluation by THL is available, it is a highly accurate technique in comparison with the laparoscopy.
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Cited by (30)
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- Transvaginal hydrolaparoscopy and laparoscopy 2019
- Transvaginal Tubal Sterilization and Hysterectomy 2017
- Performance of outpatient transvaginal hydrolaparoscopy 2016
- In-office transvaginal hydrolaparoscopy: a step-by-step, intraoperative pain evaluation 2015
- Proximal Tubal Disease 2015
- Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion 2013
- Rationale of first-line endoscopy-based fertility exploration using transvaginal hydrolaparoscopy and minihysteroscopy 2012
- Contre la pratique systématique d’une cœlioscopie dans le bilan d’une infertilité 2010
- Investigation of the female patient 2010
- Preoperative Evaluation of Posterior Deep-Infiltrating Endometriosis Demonstrates a Relationship with Urinary Dysfunction and Parametrial Involvement 2010
- Transvaginal Hydrolaparoscopy: Practices in French Teaching Hospitals 2008
- Atlas of Transvaginal Endoscopy 2007
- Prise en charge de l'endométriose: les bonnes pratiques de la cœlioscopie diagnostique 2007
- Fertilité tubaire et chirurgie : le point de vue du gynécologue 2007
- Major complications and outcome of diagnostic and operative transvaginal hydrolaparoscopy 2007
- Transvaginal hydrolaparoscopy: an advance or a gimmick! 2006
- Complex one-stop investigation of infertility: transvaginal hydrolaparoscopy 2006
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- Transvaginal endoscopy: new technique evaluating female infertility. Three Mediterranean countries’ experiences 2005
- The cost of out-patient culdoscopy compared to in-patient laparoscopy in women with infertility 2005
- Posterior Cul-de-Sac Obliteration Associated with Endometriosis: MR Imaging Evaluation 2005
- Progress in transvaginal hydrolaparoscopy 2004
- Usefulness and prognostic value of transvaginal hydrolaparoscopy in infertile women 2003
- Transvaginal Laparoscopy 2003
- Experience with 109 Cases of Transvaginal Hydrolaparoscopy 2003
- Transvaginal hydrolaparoscopy: a new diagnostic tool in infertility investigation 2002
- Transvaginal Hydrolaparoscopy 2002
- Results of a Prospective Comparative Study of Transvaginal Hydrolaparoscopy and Chromolaparoscopy in the Diagnostics of Infertility 2001
- Identification of “subtle” adhesions? 2001
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