Should diagnostic hysteroscopy be a routine procedure during diagnostic laparoscopy in infertile women?

Godinjak Z, Zulfo Godinjak, Edin Idrizbegović, Idrizbegović E
Bosnian journal of basic medical sciences · 2008 · doi:10.17305/bjbms.2008.2996 · PMID:18318671 · PMC5724875
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This retrospective study found that combined simultaneous laparoscopy and hysteroscopy in 360 infertile women identified tubal blockages, adhesions, myomas, polyps, Asherman's syndrome, uterine anomalies, endometriosis, and cysts.

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This retrospective study evaluated whether performing simultaneous diagnostic hysteroscopy during diagnostic laparoscopy improves assessment in 360 infertile women undergoing routine infertility workup. Using combined procedures, the authors reported detection of tubal occlusion, pelvic adhesions, myomas, endometrial polyps and Asherman syndrome, uterine anomalies, and other pathologies, with endometriosis identified in 51 women and several findings attributed to either laparoscopy or hysteroscopy. The main limitation is the retrospective design and the lack of a comparator group that did not receive combined hysteroscopy and laparoscopy, so the incremental diagnostic value of hysteroscopy specifically cannot be quantified. Relevance to endometriosis: the paper explicitly reports that endometriosis was found in 14.16% of the infertile women assessed with combined laparoscopy and hysteroscopy, though its central focus is on the routine combined diagnostic approach for infertility.

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Abstract

The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility. In a retrospective study, 360 infertile women underwent complete fertility evaluation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of the routine infertility evaluation. Laparoscopy and hysteroscopy were successful in 360 patients. Bilateral tubes were blocked in 18 (5%) and unilateral tubal occlusion were in 30 (8,33%) of patients. Pelvic adhesions were revealed in 40 (11,11%), and myomas in 42 (11,65%) out of that 31 (8,6%) were revealed by laparoscopy and 11 (3,05%) by hysteroscopy. Endometrial polyps were revealed in 26 (7,22%) and Syndrome Asherman in 3(0,83%) of patients. Uterine anomaly was found in 19 (5,27%) of cases and out of that septate uterus in 7 (37,15%), bicornuate uterus in 5 (26,31%), arcuate uterus in 4 (21,26%) and uterus unicornu cum cornu rudimentario in 3 (15,27%) of uterine anomalies. Endometriosis was found in 51 (14,16%), dermoid cysts in 8 (2,22%) and in 16 (4,44%) functional cysts of patients. Also, Fitz-Hugh-Curtis syndrome was revealed in 23 (6,11%) of our patients. Laparoscopy and hysteroscopy play very important role as diagnostic tools in the infertility women. Combined diagnostic simultaneous laparoscopy and hysteroscopy should be performed in all infertile patients before the treatment.
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Should Diagnostic Hysteroscopy be a Routine Procedure During Diagnostic Laparoscopy in Infertile Women? DOI: https://doi.org/10.17305/bjbms.2008.2996Keywords: laparoscopy, hysteroscopy, infertilityAbstract The aim of this study was to clarify the role of simultaneous combined diagnostic approach using laparoscopy and hysteroscopy in the evaluation of female infertility. In a retrospective study, 360 infertile women underwent complete fertility evaluation. All the patients were examined by simultaneous combined laparoscopy and hysteroscopy as a part of the routine infertility evaluation. Laparoscopy and hysteroscopy were successful in 360 patients. Bilateral tubes were blocked in 18 (5%) and unilateral tubal occlusion were in 30 (8,33%) of patients. Pelvic adhesions were revealed in 40 (11,11%), and myomas in 42 (11,65%) out of that 31 (8,6%) were revealed by laparoscopy and 11 (3,05%) by hysteroscopy. Endometrial polyps were revealed in 26 (7,22%) and Syndrome Asherman in 3(0,83%) of patients. Uterine anomaly was found in 19 (5,27%) of cases and out of that septate uterus in 7 (37,15%), bicornuate uterus in 5 (26,31%), arcuate uterus in 4 (21,26%) and uterus unicornu cum cornu rudimentario in 3 (15,27%) of uterine anomalies. Endometriosis was found in 51 (14,16%), dermoid cysts in 8 (2,22%) and in 16 (4,44%) functional cysts of patients. Also, Fitz-Hugh- Curtis syndrome was revealed in 23 (6,11%) of our patients. Laparoscopy and hysteroscopy play very important role as diagnostic tools in the infertility women. Combined diagnostic simultaneous laparoscopy and hysteroscopy should be performed in all infertile patients before the treatment. Citations Downloads Published Issue Section Categories How to Cite Accepted 2018-01-15 Published 2008-02-20

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Condition tags

endometriosisinfertility

MeSH descriptors

Hysteroscopy Infertility, Female Infertility, Female Laparoscopy Adult Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tube Diseases Female Humans Hysteroscopy Infertility, Female Laparoscopy Leiomyoma

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