Tolerability of the mini-pan-endoscopic approach (transvaginal hydrolaparoscopy and minihysteroscopy) versus hysterosalpingography in an outpatient infertility investigation.
OBJECTIVE
To compare the acceptance and tolerability of the mini-pan-endoscopic approach (transvaginal hydrolaparoscopy [THL] combined with minihysteroscopy) versus hysterosalpingography (HSG) for evaluating tubal patency and the uterine cavity in an outpatient infertility investigation.


METHODS
Randomized controlled study.


METHODS
University hospital.


METHODS
Twenty-three infertile patients without obvious pelvic pathology.


METHODS
Women were randomly divided into two groups. One group underwent minihysteroscopy and THL with tube chromoperturbation as first investigation and HSG within the following 7 days, while in the other group the investigation sequence was inverted. Women reported pain experienced before and at the end of procedures.


METHODS
Mean duration of procedures, level of pain experienced, diagnostic agreement about tubal patency and uterine cavity normality.


RESULTS
THL and minihysteroscopy took significantly more time but was significantly less painful than HSG. Regarding tubal patency, in 95.5% of cases THL agreed with HSG. In one case, HSG diagnosed a bilateral obstruction of tubes, whereas at THL a bilateral spreading of methylene blue was seen. Agreement on intrauterine pathologies between minihysteroscopy and HSG was poor (43%); the number of intrauterine abnormalities found at hysteroscopy was significantly greater than at HSG.


CONCLUSIONS
THL in association with minihysteroscopy provided more information and was better tolerated than HSG in an outpatient infertility investigation.
Cicinelli
E
E
First Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it
Matteo
M
M
Causio
F
F
Schonauer
L M
LM
Pinto
V
V
Galantino
P
P
D000328:Adult; D005184:Fallopian Tube Diseases / Q000473:pathology; D005186:Fallopian Tube Patency Tests; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000009:adverse effects / Q000592:standards*; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D007247:Infertility, Female / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards*; D010045:Outpatients; D010146:Pain / Q000209:etiology