Diagnostic accuracy of transvaginal hydrolaparoscopy in infertility

Objective: To determine whether the accuracy of transvaginal hydrolaparosco py is comparable to that of standard laparoscopy for the diagnosis of infer tility. 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 hyd rolaparoscopy and standard laparoscopy and reported the observations in a c onfidential manner to a third person. Main Outcome Measure(s): Endometriosis, adhesions, and other pelvic patholo gy related to infertility. Result(s): Minimal or mild endometriosis was diagnosed in seven patients an d sequelae of pelvic inflammatory disease in one patient at both procedures . The interobserver agreement for tuboovarian adhesions was 95% at transvag inal hydrolaparoscopy and 74% at standard laparoscopy. Ovarian adhesions we re detected in 63% at transvaginal hydrolaparoscopy and in 37% at standard laparoscopy. Conclusion(s): Transvaginal hydrolaparoscopy is comparable in accuracy to s tandard laparoscopy for the diagnosis of adhesions and endometriosis in inf ertile patients without obvious pathology. (Fertil Steril(R) 1999; 71:1157- 60, (C) 1999 by American Society for Reproductive Medicine.).