Document Detail

Transvaginal hydrolaparoscopy vs. conventional laparoscopy for evaluating unexplained primary infertility in women.
MedLine Citation:
PMID:  12216426     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To verify the usefulness and reliability of transvaginal hydrolaparoscopy (THL) as a screening tool for evaluating infertility in women in comparison with conventional diagnostic laparoscopy. STUDY DESIGN: Sixty consecutive women with unexplained primary infertility were prospectively enrolled into the study. After examination of the whole pelvic cavity, tubal patency was evaluated and the uterine cavity studied by hysteroscopy. Immediately after THL, conventional laparoscopy was performed. Main outcome measures were the success rate of accessing the pouch of Douglas, rate of complete examinations, rate of complications and accuracy of THL in comparison with laparoscopy. RESULTS: Success rate of accessing the pouch of Douglas and performing THL was 93.3%. The rate of complete evaluation of all the pelvic structures was 76.8%. In studying tubal pathology, 77.8% agreement was found between the two techniques. Diagnosis of endometriosis was correct in 55.5% of patients. Overall, THL results correlated closely with conventional laparoscopic results in 92.86%, but the diagnostic accuracy of THL was 100% in cases of complete pelvic evaluation. CONCLUSION: THL is a feasible, reliable and safe procedure and can be considered an alternative procedure for evaluating infertility in women. In cases of incomplete pelvic evaluation or abnormal findings, conventional laparoscopy is indicated as the second step in the evaluation.
Alessandro Casa; Francesco Sesti; Massimiliano Marziali; Emilio Piccione
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  47     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-09     Completed Date:  2003-01-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-20     Citation Subset:  IM    
Division of Obstetrics and Gynecology, San Pietro Fatebenefratelli Hospital, Section of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome, Italy.
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MeSH Terms
Feasibility Studies
Genital Diseases, Female / complications,  pathology*,  surgery*
Infertility, Female / etiology,  pathology*,  surgery*
Laparoscopy / methods*
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Vagina / pathology*,  surgery*

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