Open AccessUltrasonographically guided transvaginal hydrolaparoscopy
Author(s) -
SOBEK ALEŠ,
HAMMADEH MOHAMED,
VODICKA JAN,
SOBEK ALEŠ
Publication year - 2008
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340802392763
Subject(s) - medicine , asymptomatic , laparoscopy , abdominal cavity , pelvic examination , pouch , outpatient clinic , pelvic cavity , surgery , transvaginal ultrasound , endometriosis , gynecology , radiology , ultrasound
Abstract Transvaginal hydrolaparoscopy was introduced as an outpatient procedure to examine the tubo‐ovarian complex in infertile women. We evaluated ultrasonographically guided transvaginal hydrolaparoscopy (UTHL) as a modified technique for pelvic examination in 562 infertile women without overt evidence of pelvic pathology. Access to the abdominal cavity was observed by ultrasound and examination of the pelvic structures was done by hydrolaparoscopy using saline solution. Access was successful in all cases. No perforation of bowel or rectum was detected. Bilateral visualization of the tubo‐ovarian complex was successful in 96% of women. Mild asymptomatic peri‐ovarian adhesions were detected in 17% of the women, 4.9% had grade I endometriosis. There was unilateral tubal occlusion in 5%, and bilateral in 3.6%. In 13.9% elective operative laparoscopy for tubal obstruction and/or adhesions was recommended. UTHL is a safe outpatient procedure for examination of the tubo‐ovarian complex. The use of ultrasound increases the rate of successful access to the pouch of Douglas and minimizes complications.