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Tros R, van Kessel M, van Kuijk S, Oosterhuis G, Kuchenbecker W, Kwee J, Bongers M, Mol B, Koks C. The capacity of transvaginal hydrolaparoscopy versus hysterosalpingography to diagnose tubal pathology in the work-up of subfertile women, a randomised clinical trial. Eur J Obstet Gynecol Reprod Biol 2019; 236:127-132. [DOI: 10.1016/j.ejogrb.2019.02.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
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Coenders-Tros R, van Kessel M, Vernooij M, Oosterhuis G, Kuchenbecker W, Mol B, Koks C. Performance of outpatient transvaginal hydrolaparoscopy. Hum Reprod 2016; 31:2285-91. [DOI: 10.1093/humrep/dew161] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/20/2016] [Indexed: 01/10/2023] Open
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Giampaolino P, Pellicano M, Tommaselli GA, Bifulco G, Simioli S, Nappi C, Di Carlo C. In-office transvaginal hydrolaparoscopy: a step-by-step, intraoperative pain evaluation. Arch Gynecol Obstet 2015; 292:1373-7. [DOI: 10.1007/s00404-015-3750-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
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Braidy C, Nazac A, Legendre G, Capmas P, Fernandez H. [Comparison of fertiloscopy versus laparoscopy in the exploration of the infertility: analysis of the literature]. ACTA ACUST UNITED AC 2014; 43:488-95. [PMID: 24767305 DOI: 10.1016/j.jgyn.2014.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 03/10/2014] [Accepted: 03/13/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fertiloscopy is a recent technique designed to explore the tubo-ovarian axis in unexplained infertility. It is a simple outpatient technique, allowing to perform operative procedures, but its position relative to laparoscopy is yet to be defined. MATERIAL AND METHODS A thorough and extensive bibliographical search was undertaken to fully embrace the question, challenging Medline at the National Library of Medicine, Cochrane Library, National Guideline Clearinghouse, Health Technology Assessment Database. All the retrieved articles were classified as either descriptive or comparative studies and evaluated on a set of criteria. RESULTS Most of the papers described case series coming from a few teams, focusing mainly on the technical aspect of the procedure, like the access rate to the posterior cul-de-sac, the success rate in visualizing the pelvis, the complications rate (mainly rectal perforation), and its operative performance in drilling ovaries for resistant polycystic ovarian syndrome. Comparative studies numbered six trials. They all followed the same design, fertiloscopy preceding conventional laparoscopy in patients taken as their own control. The concordance rate between the two modalities reaches 80% in terms of tubal pathology, adherences and endometriosis, with an estimated reduction of laparoscopies varying from 40% to 93%. CONCLUSION The current literature shows a concordance between fertiloscopy and conventional laparoscopic findings for certain parameters in cases of tubal pathology, adherences and endometriosis. The relative positions of these two modalities in unexplained infertility still remain elusive.
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Affiliation(s)
- C Braidy
- Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - A Nazac
- Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - G Legendre
- Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - P Capmas
- Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - H Fernandez
- Service de gynécologie obstétrique, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Inserm U1018, 82, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
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Kataoka A, Hirakawa S, Iwamoto M, Sakumura Y, Yoshinaga R. Transvaginal hydrolaparoscopy by flexible fiberscope--a study of preliminary cases. Kurume Med J 2011; 58:99-103. [PMID: 23047139 DOI: 10.2739/kurumemedj.58.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Transvaginal hydrolaparoscopy (THL) has become a first-line procedure in infertile women, and THL by flexible fiberscope (THLF) is a less traumatic and a more suitable outpatient procedure than diagnostic laparoscopy. We performed THLF on infertile women based on four indications; (i) tubal obstruction and/or peritubal adhesion as suggested by hysterosalpingography (HSG); (ii) serum antibody against Chlamydia (C) positive for trachomatis; (iii) diagnosis of early stage endometriosis; and (iv) unexplained infertility. Seven women with a chief complaint of infertility were the subjects of the present study. Two of the 7 cases had a history of gynecological surgery. Six of 7 cases had a history of C. trachomatis infection. Four cases had abnormal findings of fallopian tubal patency in hysterosalpingography. Parafallopean tubal atresia and tubal obstruction were observed in 4 cases by THLF. In one case the bilateral ovaries were extremely small and atrophic. None of the cases had serious complications after THLF. After the THLF, six women were able to have a baby by assisted reproductive technology (ART) within two years. As THL was developed using a solid scope, indications for THL have been limited, and have excluded cases with retroverted uterus or peritoneal surgical history. In the present study, THL using a fiberscope was carried out in infertile women with retroverted uterus, and in women with a history of peritoneal cavity surgery to examine the feasibility of extending the indications for THL. Findings on the THLF were given precedence in deciding further treatment strategies. We believe that THLF can be useful in helping patients with these indications to successfully achieve early pregnancy. This study is the first trial of THLF.
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Affiliation(s)
- Akio Kataoka
- Clinic of Obstetrics and Gynecology, Kataoka Ladies Clinic, Yatsushiro, Japan
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Escobar PF, Starks D, Fader AN, Catenacci M, Falcone T. Laparoendoscopic single-site and natural orifice surgery in gynecology. Fertil Steril 2010; 94:2497-502. [DOI: 10.1016/j.fertnstert.2010.08.018] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 07/02/2010] [Accepted: 08/10/2010] [Indexed: 02/03/2023]
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Daraï E, Rouzier R, Ballester M. Transvaginal Hydrolaparoscopy: Practices in French Teaching Hospitals. J Minim Invasive Gynecol 2008; 15:273-6. [DOI: 10.1016/j.jmig.2008.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2007] [Revised: 12/22/2007] [Accepted: 01/09/2008] [Indexed: 10/22/2022]
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Transvaginal access: a safe technique for tubo-ovarian exploration in infertility? Review of the literature. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/s10397-008-0374-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shibahara H, Shimada K, Kikuchi K, Hirano Y, Suzuki T, Takamizawa S, Fujiwara H, Suzuki M. Major complications and outcome of diagnostic and operative transvaginal hydrolaparoscopy. J Obstet Gynaecol Res 2007; 33:705-9. [PMID: 17845334 DOI: 10.1111/j.1447-0756.2007.00636.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Transvaginal hydrolaparoscopy (THL) has recently been developed as a less invasive alternative to conventional laparoscopy. There are some reports that described the usefulness and prognostic value of diagnostic THL in infertile women. Moreover, operative THL such as ovarian drilling for unovulatory women with polycystic ovarian syndrome (PCOS) to induce ovulation has also been found to be as effective as that by conventional laparoscopy. The risk of bowel injury and sepsis by transvaginal access with culdoscopy was higher than that with laparoscopy in the previous reports. The purpose of the present study was to examine the risk of diagnostic and operative THL according to two case studies with a literature review. METHODS The authors carried out diagnostic or operative THL in 177 infertile women, aged 22-43 years. Major complications during THL and a review of the literature were analyzed. RESULTS Two cases of bowel injury were diagnosed during diagnostic THL. No complication occurred during operative THL. In total, the incidence of bowel injury was 1.1%. The injuries were diagnosed during THL and treated expectantly under strict conditions in both cases. Ten studies in the literature reported a total of 4232 procedures, including 26 bowel injuries (0.61%) and one perforation of a retroflexed uterus (0.02%). CONCLUSIONS The usefulness of THL for diagnostic and operative purposes is in no doubt. However, informed consent should be obtained and vigilance before and during THL should be maintained, although it can be done on an outpatient clinic basis.
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Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology, School of Medicine, Jichi Medical University and Center for Reproductive Medicine, Jichi Medical University Hospital, Yakushiji, Shimotsuke, Tochigi, Japan.
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Verhoeven HC, Brosens I. Transvaginal hydrolaparoscopy, its history and present indication. MINIM INVASIV THER 2007; 14:175-80. [PMID: 16754160 DOI: 10.1080/13645700510033949] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The investigation of the infertile couple by hysterosalpingography and laparoscopy is currently a highly debated issue. The purpose of this paper is to review whether transvaginal hydrolaparoscopy (THL), a new culdoscopic approach, in combination with minihysteroscopy and chromopertubation test can be offered as a complete one-stop endoscopic exploration. The technique allows complete endoscopic exploration of the reproductive tract in an office or outpatient setting and has been validated during the past years for its accuracy, safety and patient tolerance. Although further prospective randomized studies are required to prove the superiority and cost-benefit of transvaginal hydrolaparoscopy as diagnostic tool in comparison with hysterosalpingography (HSG) and laparoscopy, the technique can be proposed as a safe first-line investigation predicting the fertility outcome in women.
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Affiliation(s)
- Hugo C Verhoeven
- Center for Reproductive Medicine and Endocrinology, Duesseldorf, Germany.
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Svenstrup HF, Fedder J, Kristoffersen SE, Trolle B, Birkelund S, Christiansen G. Mycoplasma genitalium, Chlamydia trachomatis, and tubal factor infertility--a prospective study. Fertil Steril 2007; 90:513-20. [PMID: 17548070 DOI: 10.1016/j.fertnstert.2006.12.056] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Revised: 12/12/2006] [Accepted: 12/12/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the presence of M. genitalium and C. trachomatis in women attending fertility clinics and to follow these women for the effects of previous infections or tubal damage on pregnancy rate and outcome. DESIGN Prospective study. SETTING Fertility clinics and university. PATIENT(S) Two hundred twelve couples attending fertility clinics. INTERVENTION(S) Blood and cervical swab samples from the women. Tubal status was assessed by culdoscopy and/or laparoscopy. MAIN OUTCOME MEASURE(S) Presence of M. genitalium and C. trachomatis was determined by polymerase chain reaction. Serum samples were tested for antibodies against M. genitalium and C. trachomatis. RESULT(S) One swap sample was positive to C. trachomatis and none positive to M. genitalium. Thirty of the 194 women had tubal factor infertility (TFI); 23% and 17% of women with TFI had antibodies to C. trachomatis and M. genitalium, respectively, compared with 15% and 4%, respectively, of women with normal tubes; 36% and 14% of women with a self-reported history of pelvic inflammatory disease (PID) were seropositive to C. trachomatis and M. genitalium, respectively, compared with 10% and 6%, respectively, of women without past PID. CONCLUSION(S) A strong antibody response against M. genitalium or C. trachomatis but no sign of current or chronic infection was found in women with TFI, indicating that previous infections caused by these microorganisms may have resulted in permanent damage and occlusion of the fallopian tubes.
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Affiliation(s)
- Helle Friis Svenstrup
- Institute of Medical Microbiology and Immunology, University of Aarhus, Arhus, Denmark.
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Shibahara H, Hirano Y, Kikuchi K, Suzuki T, Takamizawa S, Suzuki M. Postoperative endocrine alterations and clinical outcome of infertile women with polycystic ovary syndrome after transvaginal hydrolaparoscopic ovarian drilling. Fertil Steril 2006; 85:244-6. [PMID: 16412768 DOI: 10.1016/j.fertnstert.2005.07.1284] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Revised: 07/12/2005] [Accepted: 07/12/2005] [Indexed: 11/22/2022]
Abstract
Transvaginal hydrolaparoscopic ovarian drilling (THLOD) appears to be an effective minimally invasive procedure to induce ovulation in women with polycystic ovary syndrome (PCOS). Postoperative endocrinological alterations following THLOD show significant decrease of serum LH and testosterone concentrations.
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Affiliation(s)
- Hiroaki Shibahara
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan.
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Suzuki T, Shibahara H, Hirano Y, Fujiwara H, Takamizawa S, Suzuki M. Feasibility and clinical significance of endoluminal assessment by transvaginal salpingoscopy during transvaginal hydrolaparoscopy in infertile women. J Minim Invasive Gynecol 2005; 12:420-5. [PMID: 16213428 DOI: 10.1016/j.jmig.2005.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 04/05/2005] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE To investigate the feasibility and clinical usefulness of transvaginal salpingoscopy (TS) during transvaginal hydrolaparoscopy (THL) in infertile women. DESIGN Retrospective study (Canadian Task Force classification II-3). SETTING Jichi Medical School, Tochigi, Japan. PATIENTS One hundred thirty infertile women, aged 22 to 43 years, who underwent THL. INTERVENTIONS Transvaginal salpingoscopy findings in comparison with THL findings. MEASUREMENTS AND MAIN RESULTS Transvaginal salpingoscopy could be performed in 41.0% of the attempted tubes. In comparing rates of successful TS in relation to tubal patency, tubal morphology, and past Chlamydia trachomatis infection, patent tubes and normal-appearing tubes classified with normal morphology had a significantly higher TS success rate. However, past C. trachomatis infection did not affect the success of TS. There was a significant correlation between salpingoscopic and laparoscopic findings; however, there were no significant correlations between salpingoscopic findings and C. trachomatis antibody titers. CONCLUSIONS These findings suggest that TS can be performed simultaneously in some infertile women undergoing THL especially those with patent tubes or with normal-appearing tubes. Further studies are required to show the usefulness of intratubal exploration in assessing tubal infertility.
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Affiliation(s)
- Tatsuya Suzuki
- Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan
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