Diagnostic and operative transvaginal hydrolaparoscopy for infertility and pelvic pain
1Advanced Women's Health Institute, University of Colorado Health Sciences Center, 210 University Boulevard, Suite 500, Denver, CO 80206, USA.
Study Objective:
To review our experience with diagnostic and operative transvaginal hydrolaparoscopy (THL), a procedure that is less invasive than operative laparoscopy.
Design:
Prospective, observational cohort study (Canadian Task Force classification II-2).
Setting:
Private institute and university-affiliated hospital.
Patients:
Twenty-nine women with infertility and 11 with pelvic pain.
Interventions:
Diagnostic and operative THL.
Measurements And Main Results:
Thirty-five (88%) diagnostic THLs were performed in the office and the other five were done in hospital for insurance reasons; all six operative THLs were performed in the office under conscious sedation. The procedure was conclusive (all organs seen) in 37 patients (93%). Based on THL, no further surgical intervention was recommended in 18 (62%) infertile women and 5 (45%) of those with pain. Further surgical intervention was required in 5 (56%) of 9 infertility patients with a previous normal hysterosalpingogram (HSG) and 6 (32%) of 19 infertility patients with no previous HSG.
Conclusion:
Transvaginal hydrolaparoscopy can be performed in the office with minimal pain, with a conclusive examination anticipated in 93% of cases. The procedure is more accurate than HSG and similar to laparoscopy.
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