Human Reproduction, Vol 13, 99-103, Copyright © 1998 by Oxford University Press
S Gordts, R Campo, L Rombauts and I Brosens
A new technique called transvaginal hydrolaparoscopy is described for the
exploration of the tubo-ovarian structures in infertile patients without
obvious pelvic pathology. It aims to be an acceptable alternative to
diagnostic laparoscopy, a standard but not innocuous procedure which
infrequently reveals pathology in the asymptomatic patient. Transvaginal
hydrolaparoscopy copy is performed under local anaesthesia using a small
diameter optic with the patient in the dorsal position. Cavity distension
is achieved with normal saline. Transvaginal hydrolaparoscopy does not
provide the familiar and panoramic view of the pelvis given by laparoscopy,
but it does have several advantages. These include accurate and atraumatic
inspection of adnexal structures without manipulation, with the opportunity
to perform dye hydrotubation and salpingoscopy. The risks of a general
anaesthetic are avoided, and there is less risk of trauma to major vessels.
The high patient acceptability makes transvaginal hydrolaparoscopy suitable
as an early stage procedure in the investigation of infertility and as a
repeat or second look procedure. Minor operative procedures such as biopsy
and adhesiolysis can also be performed. In patients with obvious pelvic
pathology, diagnostic laparoscopy will obviously remain the procedure of
choice. Transvaginal hydrolaparoscopy deserves full evaluation of its
accuracy, risks and benefits before it can be accepted as a new first line
technique in gynaecological practice.
ARTICLES
Transvaginal hydrolaparoscopy as an outpatient procedure for infertility investigation
Leuven Institute for Fertility and Embryology, Belgium.
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