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Diagnostic accuracy of transvaginal hydrolaparoscopy in infertility
R Campo1, S Gordts, L Rombauts
1Leuven Institute of Fertility and Embryology, Belgium.
Objective:
To determine whether the accuracy of transvaginal hydrolaparoscopy is comparable to that of standard laparoscopy for the diagnosis of infertility.
Design:
Prospective, comparative study.
Setting:
General hospital in Belgium.
Patient(S):
Ten infertile patients without obvious pelvic pathology.
Intervention(S):
Two gynecologists independently performed transvaginal hydrolaparoscopy and standard laparoscopy and reported the observations in a confidential manner to a third person.
Main Outcome Measure(S):
Endometriosis, adhesions, and other pelvic pathology related to infertility.
Result(S):
Minimal or mild endometriosis was diagnosed in seven patients and sequelae of pelvic inflammatory disease in one patient at both procedures. The interobserver agreement for tuboovarian adhesions was 95% at transvaginal hydrolaparoscopy and 74% at standard laparoscopy. Ovarian adhesions were detected in 63% at transvaginal hydrolaparoscopy and in 37% at standard laparoscopy.
Conclusion(S):
Transvaginal hydrolaparoscopy is comparable in accuracy to standard laparoscopy for the diagnosis of adhesions and endometriosis in infertile patients without obvious pathology.