Transvaginal hydrolaparoscopy but not standard laparoscopy reveals subtle endometriotic adhesions of the ovary.
OBJECTIVE
To determine whether transvaginal hydrolaparoscopy is superior to standard laparoscopy for detection of subtle endometriotic adhesions of the ovary.


METHODS
Videotapes of standard laparoscopy and transvaginal hydrolaparoscopy were viewed by an independent observer in random order and in a blinded manner.


METHODS
Tertiary referral centers for infertility.


METHODS
Patients with minimal or mild endometriosis (n = 11) and unexplained infertility (n = 10) on standard laparoscopy from a group of 43 patients with infertility who were undergoing both studies.


METHODS
Transvaginal hydrolaparoscopy followed by standard laparoscopy.


METHODS
Detection of unexplained ovarian adhesions.


RESULTS
Patients with minimal and mild endometriosis and unexplained infertility had significantly more ovarian adhesions on transvaginal hydrolaparoscopy than on standard laparoscopy. The subtle adhesions seen on transvaginal hydrolaparoscopy but not on standard laparoscopy were filmy, microvascularized, and nonconnecting.


CONCLUSIONS
Unexplained ovarian adhesions are frequently detected on transvaginal hydrolaparoscopy but not on standard laparoscopy in infertile patients with minimal and mild endometriosis and unexplained infertility.
Brosens
I
I
Leuven Institute for Fertility and Embryology, Leuven, Belgium.
Gordts
S
S
Campo
R
R
D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000473:pathology; D010535:Laparoscopy / Q000379:methods*; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000473:pathology; D000267:Tissue Adhesions / Q000175:diagnosis / Q000473:pathology; D014743:Videotape Recording