Tubal and peritoneal factors in the infertile woman: use of patient history in selection of diagnostic and therapeutic surgical procedures.
For facilities with both ambulatory and inpatient surgical capabilities, we have attempted to develop an efficient strategy for the evaluation of infertile women. The strategy was intended to (1) avoid inpatient laparoscopy, (2) minimize the number of patients having laparoscopy who subsequently required laparotomy, and (3) minimize hysterosalpingography (HSG). Patients were selected for ambulatory laparoscopy or inpatient laparotomy by means of an algorithm based on their history and the selective use of HSG. Laparoscopy was avoided in 18.1% of patients and HSG in 41.6% of patients. We conclude that, when both inpatient and outpatient surgical facilities are available, the evaluation of female infertility may not always require HSG or laparoscopy.
Opsahl
M S
MS
National Naval Medical Center, Bethesda, Maryland 20814.
Klein
T A
TA
D000465:Algorithms; D005187:Fallopian Tubes / Q000503:physiopathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D010535:Laparoscopy; D007813:Laparotomy; D008962:Models, Theoretical; D010529:Peritoneal Cavity; D012189:Retrospective Studies