Diagnostic accuracy of transvaginal hydrolaparoscopy in infertility.

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.