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.
Moore
Michael L
ML
Advanced Women's Health Institute, University of Colorado Health Sciences Center, 210 University Boulevard, Suite 500, Denver, CO 80206, USA.
Cohen
Mel
M
Liu
Grace Y
GY
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