Experience with 109 cases of transvaginal hydrolaparoscopy.
We conducted a prospective review of our experience with 109 transvaginal hydrolaparoscopies (THLs) performed in 97 women. The THL was considered complete in 101 procedures (93%) and adequate for management in 105 (96%). Two complications occurred (1.8%), one failed entry and one perforation of a retroflexed uterus. Diagnoses for 67 infertile patients were normal pelvis in 34 (51%), endometriosis in 14 (21%), adhesions in 6 (9%), and tubal obstruction in 10 (15%); 3 THLs (4%) were considered incomplete. Of 17 women with dysmenorrhea, a normal pelvis was found in 8 (47%) and endometriosis in 9 (53%). In 11 patients with pelvic pain endometriosis was found in 4 (36%), normal pelvis in 3 (27%), and adhesions in 3 (27%); THL was incomplete in 1 (9%). Six infertile patients (9%) had operative laparoscopy and 10 (15%) operative THL; 6 (9%) were counseled to seek in vitro fertilization. Pregnancy occurred in 16 patients (24%). Analog pain scores (0 = no pain, 10 = worst pain) were tracked in 39 consecutive patients. Pain during trocar insertion averaged 4.2 +/- 0.5, 2.2 +/- 0.2 at midprocedure, and 1.1 +/- 0.1 at the end of THL. We believe that THL should be considered instead of hysterosalpingogram and laparoscopy in selected patients.
Advanced Women's Health Institute, University of Colorado Health Sciences Center, 210 University Boulevard, Suite 500, Denver, CO 80206, USA.
Michael L
ML
Moore
Mel
M
Cohen
Grace Y
GY
Liu
D015331:Cohort Studies; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000601:surgery; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014621:Vagina