OBJECTIVE: To determine whether the accuracy of transvaginal hydrolaparoscopy is comparable to that of standard laparoscopy for the diagnosis of infertility. DESIGN: Prospective, comparative study. SETTING: General hospital in Belgium. PATIENT(S): Ten infertile patients without obvious pelvic pathology. INTERVENTION(S): Two gynecologists independently performed transvaginal hydrolaparoscopy and standard laparoscopy and reported the observations in a confidential manner to a third person. MAIN OUTCOME MEASURE(S): Endometriosis, adhesions, and other pelvic pathology related to infertility. RESULT(S): Minimal or mild endometriosis was diagnosed in seven patients and sequelae of pelvic inflammatory disease in one patient at both procedures. The interobserver agreement for tuboovarian adhesions was 95% at transvaginal hydrolaparoscopy and 74% at standard laparoscopy. Ovarian adhesions were detected in 63% at transvaginal hydrolaparoscopy and in 37% at standard laparoscopy. CONCLUSION(S): Transvaginal hydrolaparoscopy is comparable in accuracy to standard laparoscopy for the diagnosis of adhesions and endometriosis in infertile patients without obvious pathology.
OBJECTIVE: To determine whether the accuracy of transvaginal hydrolaparoscopy is comparable to that of standard laparoscopy for the diagnosis of infertility. DESIGN: Prospective, comparative study. SETTING: General hospital in Belgium. PATIENT(S): Ten infertilepatients without obvious pelvic pathology. INTERVENTION(S): Two gynecologists independently performed transvaginal hydrolaparoscopy and standard laparoscopy and reported the observations in a confidential manner to a third person. MAIN OUTCOME MEASURE(S): Endometriosis, adhesions, and other pelvic pathology related to infertility. RESULT(S): Minimal or mild endometriosis was diagnosed in seven patients and sequelae of pelvic inflammatory disease in one patient at both procedures. The interobserver agreement for tuboovarian adhesions was 95% at transvaginal hydrolaparoscopy and 74% at standard laparoscopy. Ovarian adhesions were detected in 63% at transvaginal hydrolaparoscopy and in 37% at standard laparoscopy. CONCLUSION(S): Transvaginal hydrolaparoscopy is comparable in accuracy to standard laparoscopy for the diagnosis of adhesions and endometriosis in infertilepatients without obvious pathology.