Results of a Prospective Comparative Study of Transvaginal Hydrolaparoscopy and Chromolaparoscopy in the Diagnostics of Infertility

F Nawroth, Frank Nawroth, D Foth, Dolores Foth, T Schmidt, Torsten C. Schmidt, T Römer, Thomas Römer
Gynecologic and obstetric investigation · 2001 · vol. 52(3) , pp. 184–188 · doi:10.1159/000052970 · PMID:11598361 · W2036775302
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Transvaginal hydrolaparoscopy demonstrated high success in detecting tubal factors and adhesions compared to chromolaparoscopy, but was less effective for endometriosis.

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Abstract

Transvaginal hydrolaparoscopy (THL) was evaluated in comparison with the already established chromolaparoscopy in the detection of tubal factors, adhesions as well as endometriosis. 43 infertile patients without previous pelvic operations and with an inconspicuous clinical examination were included in a prospective comparative study of THL and chromolaparoscopy. THL succeeded in 40 patients (93.0%). Both methods showed 100% agreement with regard to tubal factors and adhesions. However, only 72/80 tubes (90.0%) could be portrayed by THL. In contrast to this, THL failed to identify 8 of 10 laparoscopically verified endometrioses (isolated endometriosis of the bladder peritoneum in 2). No complications occurred with THL. THL could be the method of choice for the clarification of mechanical infertility factors in symptom-free patients with no suspicion of pelvic pathologies. Tubal pathologies and/or adhesions (visible during THL) should be indications for laparoscopy. In the case of inconspicuous genitals during THL and a still unfulfilled desire for offspring postoperatively, laparoscopy should be considered in order to exclude the possibility of unidentified endometriosis. Retroflexio uteri should at least be a relative contraindication for THL. Further studies are necessary to evaluate the role of THL in the diagnostic concept of infertility in the future.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Infertility, Female Laparoscopy Adult Endometriosis Endometriosis Fallopian Tube Patency Tests Fallopian Tube Patency Tests Female Humans Infertility, Female Infertility, Female Laparoscopy Prospective Studies Tissue Adhesions Tissue Adhesions

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