TRANSVAGINAL HYDROLAPAROSCOPY
Abstract
Background. Transvaginal hydrolaparoscopy (THL), which is performed under local anesthesia is a new culdoscopic technique for exploring the tubo-peritoneal infertility. The aim of paper is to present the experiences of foreign authors as well as our own experiences with this new technique.
Methods and results. In the review of the literature we found out that the accuracy of THL is comparable to laparoscopy. THL diagnosis was correlated with that of laparoscopy in 82– 93% of cases and no false positive observations were establish. The diagnostic accuracy of THL was 100%, in cases of complete pelvic evaluation. In evaluating tubal patency, it has been found that there was agreement between the THL and hysterosalpingography in 95% of cases, but THL was superior for the diagnosis of peritubal adhesions. Access to pouch of Douglas was successful in 90–96% and both adnexae were fully visualized in 77–93% of women. In 0.65% of procedures extraperitoneal rectum injury was reported, which was also the most common complication of THL. At our department 24 THL procedures were performed and our experiences are comparable with experiences of other authors.
Conclusions. THL is a safe, accurate, minimal invasive and well tolerated diagnostic method which could replace HSG and/or laparoscopy in some cases but its role in infertility evaluation is not yet clearly defined.
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References
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