Diagnostic Laparoscopy to assess tubal and pelvic pathology in patients of subfertility: A retrospective analysis

Nilam Subedi, Asmita Ghimire, Padam Raj Pant
In: Nepal Journal of Obstetrics and Gynaecology · 2022 · vol. 17(2) , pp. 26–29 · doi:10.3126/njog.v17i2.52371 · W4378567082
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This retrospective analysis of 52 subfertile patients undergoing diagnostic laparoscopy found that endometriosis was the most common associated condition with pelvic adhesions, alongside frequent tubal pathologies like hydrosalpinx and pyosalpinx.

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This retrospective study evaluated tubal and pelvic pathology in 52 patients undergoing diagnostic laparoscopy for primary or secondary infertility. The researchers identified that while many patients had normal findings, significant issues included bilateral tubal blockage, hydrosalpinx, and pelvic adhesions in nearly half of the cohort. The analysis explicitly noted that endometriosis was a common associated condition, present in 15.4% of cases alongside ovarian cysts and uterine fibroids. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Aims: To assess the tubal pathology contributing to primary and secondary infertility by laparoscopic examination. Methods: The study was carried out in the department of Obstetrics and gynecology, Grande International Hospital. This is a retrospective study conducted in tertiary care hospital over a period of 2 yrs. From 2020 February to 2022 January. All patients with complaints of infertility (primary and secondary) who were admitted, evaluated and operated for infertility in Obstetrics and Gynaecology department of Grande international Hospital. Results: Of the 52 patients minimum age was 20 and maximum was 46 with mean age of 30.52±4.885. Thirty eight patients had primary infertility and 14 had secondary. Forty patients had normal uterus while 12 had enlarged uterus. Hydrosalpinx was found in 11.5 % and 30.8% in right and left tube respectively. Pyosalpinx was found in 9.6% and 7.7% in right and left tube respectively. Bilateral tubes were patent in 22 cases while bilateral blocked tube was found in 13 cases so rest 17 cases had unilateral tubal block. Pelvic adhesions were found in 44.2 % cases. Most of them were associated with endometriosis (15.4%) followed by ovarian cyst (11.5%) and fibroid uterus (11.5%). Conclusions: Majority had normal tubal pathology followed by edematous tube, hydrosalpinx and pyosalpinx. Endometriosis, fibroid and ovarian cyst were commonly associated conditions.
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Keywords

infertility, laparoscopy, tubal pathologyAbstract Aims: To assess the tubal pathology contributing to primary and secondary infertility by laparoscopic examination.

Methods

The study was carried out in the department of Obstetrics and gynecology, Grande International Hospital. This is a retrospective study conducted in tertiary care hospital over a period of 2 yrs. From 2020 February to 2022 January. All patients with complaints of infertility (primary and secondary) who were admitted, evaluated and operated for infertility in Obstetrics and Gynaecology department of Grande international Hospital.

Results

Of the 52 patients minimum age was 20 and maximum was 46 with mean age of 30.52±4.885. Thirty eight patients had primary infertility and 14 had secondary. Forty patients had normal uterus while 12 had enlarged uterus. Hydrosalpinx was found in 11.5 % and 30.8% in right and left tube respectively. Pyosalpinx was found in 9.6% and 7.7% in right and left tube respectively. Bilateral tubes were patent in 22 cases while bilateral blocked tube was found in 13 cases so rest 17 cases had unilateral tubal block. Pelvic adhesions were found in 44.2 % cases. Most of them were associated with endometriosis (15.4%) followed by ovarian cyst (11.5%) and fibroid uterus (11.5%).

Conclusions

Majority had normal tubal pathology followed by edematous tube, hydrosalpinx and pyosalpinx. Endometriosis, fibroid and ovarian cyst were commonly associated conditions. Downloads Published How to Cite Issue Section License Copyright (c) 2022 Nilam Subedi, Asmita Ghimire, Padam Raj Pant This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Copyright on any research article in the Nepal Journal of Obstetrics and Gynaecology is retained by the author(s). The authors grant the Nepal Journal of Obstetrics and Gynaecology a license to publish the article and identify itself as the original publisher. Articles in the Nepal Journal of Obstetrics and Gynaecology are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/) This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.

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Condition tags

endometriosisinfertility

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