Transvaginal hydrolaparoscopy, its history and present indication

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Gynecological Endoscopy

Background:

• Hysterosalpingography (HSG) and laparoscopy are standard but debated methods for investigating infertility.
• There is a need for efficient, accurate, and well-tolerated diagnostic procedures for infertile couples.
• Minimally invasive techniques are increasingly explored for gynecological diagnostics.

Purpose of the Study:

• To review the potential of transvaginal hydrolaparoscopy (THL) as a comprehensive, one-stop diagnostic tool for infertility.
• To assess THL in combination with minihysteroscopy and chromopertubation for complete endoscopic exploration.
• To evaluate THL as a potential alternative to traditional infertility investigations.

Main Methods:

• Review of existing literature and validation studies on transvaginal hydrolaparoscopy.
• Description of THL as a culdoscopic approach for reproductive tract exploration.
• Combination of THL with minihysteroscopy and chromopertubation for a complete assessment.

Main Results:

• Transvaginal hydrolaparoscopy allows for complete endoscopic exploration of the reproductive tract.
• The technique is suitable for an office or outpatient setting.
• THL has demonstrated accuracy, safety, and good patient tolerance in previous validations.

Conclusions:

• Transvaginal hydrolaparoscopy, minihysteroscopy, and chromopertubation can offer a complete one-stop endoscopic exploration.
• While further randomized studies are needed to confirm superiority and cost-effectiveness, THL is a safe first-line investigation.
• THL shows potential in predicting fertility outcomes in women, offering a less invasive diagnostic option.