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https://hdl.handle.net/2440/123882
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Type: | Journal article |
Title: | Transvaginal hydrolaparoscopy and laparoscopy |
Author: | Tros, R. van Kessel, M. Oosterhuis, J. Kuchenbecker, W. Bongers, M. Mol, B.W. Koks, C. |
Citation: | Reproductive Biomedicine Online, 2020; 40(1):105-112 |
Publisher: | Elsevier |
Issue Date: | 2020 |
ISSN: | 1472-6483 1472-6491 |
Statement of Responsibility: | Rachel Tros, Mianna van Kessel, Jur Oosterhuis, Walter Kuchenbecker, Marlies Bongers, Ben Willem Mol, Carolien Koks |
Abstract: | Research Question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women. Design: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities. Results: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11 (1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29. Conclusion: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up. |
Keywords: | Fertility; laparoscopy; patency tests; transvaginal hydrolaparoscopy; tubal pathology |
Rights: | © 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved. |
DOI: | 10.1016/j.rbmo.2019.10.011 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/GNT1082548 |
Published version: | http://dx.doi.org/10.1016/j.rbmo.2019.10.011 |
Appears in Collections: | Aurora harvest 4 Obstetrics and Gynaecology publications |
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