Transvaginal hydrolaparoscopy but not standard laparoscopy reveals subtle endometriotic adhesions of the ovary

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Transvaginal hydrolaparoscopy identified subtle ovarian endometriotic adhesions that were not visible with standard laparoscopy.

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Abstract

ObjectiveTo determine whether transvaginal hydrolaparoscopy is superior to standard laparoscopy for detection of subtle endometriotic adhesions of the ovary.DesignVideotapes of standard laparoscopy and transvaginal hydrolaparoscopy were viewed by an independent observer in random order and in a blinded manner.SettingTertiary referral centers for infertility.Patient(s)Patients with minimal or mild endometriosis (n = 11) and unexplained infertility (n = 10) on standard laparoscopy from a group of 43 patients with infertility who were undergoing both studies.Intervention(s)Transvaginal hydrolaparoscopy followed by standard laparoscopy.Main outcome measure(s)Detection of unexplained ovarian adhesions.Result(s)Patients with minimal and mild endometriosis and unexplained infertility had significantly more ovarian adhesions on transvaginal hydrolaparoscopy than on standard laparoscopy. The subtle adhesions seen on transvaginal hydrolaparoscopy but not on standard laparoscopy were filmy, microvascularized, and nonconnecting.Conclusion(s)Unexplained ovarian adhesions are frequently detected on transvaginal hydrolaparoscopy but not on standard laparoscopy in infertile patients with minimal and mild endometriosis and unexplained infertility.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Ovarian Diseases Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Infertility, Female Laparoscopy Ovarian Diseases Ovarian Diseases Tissue Adhesions Tissue Adhesions Tissue Adhesions Videotape Recording

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