Office transvaginal hydrolaparoscopy for early diagnosis of pelvic endometriosis and adhesions

Study Objective. To evaluate the feasibility of a new endoscopic technique, transvaginal hydrolaparoscopy, for early office screening of subfertile wo men. Design, Retrospective, descriptive feasibility study (Canadian Task Force c lassification II-2). Setting. Office in an infertility center. Patients, One hundred fifty-seven continuous women with primary or secondar y subfertility. Intervention, Under local anesthesia, a Veress needle-cannula system was in serted into the posterior fornix with peritoneal distention by saline. Measurements and Main Results. Access was achieved in 95% of patients. In 5 8.5% the findings were normal and in 28% an explorative or operative laparo scopy was indicated. No major complication occurred. Patients' pain scores were similar to those for office hysteroscopy. Conclusion. Transvaginal hydrolaparoscopy was successfully performed in the office. The technique allows early and complete endoscopic screening of su bfertile women.