Transvaginal hydrolaparoscopy: a new diagnostic tool in infertility investigation

Kristín Jónsdóttir, Per Lundorff
Acta obstetricia et gynecologica Scandinavica · 2002 · vol. 81(9) , pp. 882–885 · doi:10.1034/j.1600-0412.2002.810915.x · PMID:12225307 · W2052476041
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Transvaginal hydrolaparoscopy successfully accessed tubo-ovarian structures in 93% of infertile women and identified pathology in 29 patients, proving safer and superior to hysterosalpingography for diagnosing adhesions.

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Abstract

BACKGROUND: To establish the value of a new technique called transvaginal hydrolaparoscopy for exploration of the tubo-ovarian structures in the management of patients with unexplained infertility. METHODS: A total of 120 women with primary or secondary infertility, and without obvious pelvic pathology, were included in the study. The first 14 patients received general anesthesia and underwent transvaginal laparoscopy immediately before standard laparoscopy. The remaining 106 patients had transvaginal laparoscopy performed under local anesthesia, with standard laparoscopy performed only on those with pathology, which required operative intervention. Information on pathology, complications, and successful access to the pouch of Douglas were recorded. RESULTS: The successful rate of access was 93%. Pathology was found in 29 patients, of whom 15 required operative laparoscopy. Also, out of 19 patients with adhesions, 11 (58%) had normal dye test bilateral, and only two (11%) had bilateral occlusion of the tubes. No complications were observed. CONCLUSION: Transvaginal hydrolaparoscopy is a safe and well-tolerated method for investigating the tubo-ovarian structures in unexplained infertility. It is superior to hysterosalpingography for diagnosis of adhesions.

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Condition tags

endometriosisinfertility

MeSH descriptors

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

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