Results of a prospective comparative study of transvaginal hydrolaparoscopy and chromolaparoscopy in the diagnostics of infertility

Transvaginal hydrolaparoscopy (THL) was evaluated in comparison with the al ready established chromolaparoscopy in the detection of tubal factors, adhe sions as well as endometriosis. 43 infertile patients without previous pelv ic operations and with an inconspicuous clinical examination were included in a prospective comparative study of THL and chromolaparoscopy. THL succee ded in 40 patients (93.0%). Both methods showed 100% agreement with regard to tubal factors and adhesions. However, only 72/80 tubes (90.0%) could be portrayed by THL. In contrast to this, THL failed to identify 8 of 10 lapar oscopically verified endometrioses (isolated endometriosis of the bladder p eritoneum in 2). No complications occurred with THL. THL could be the metho d of choice for the clarification of mechanical infertility factors in symp tom-free patients with no suspicion of pelvic pathologies. Tubal pathologie s and/or adhesions (visible during THL) should be indications for laparosco py. In the case of inconspicuous genitals during THL and a still unfulfille d desire for offspring postoperatively, laparoscopy should be considered in order to exclude the possibility of unidentified endometriosis. Retroflexi o uteri should at least be a relative contraindication for THL. Further stu dies are necessary to evaluate the role of THL in the diagnostic concept of infertility in the future. Copyright (C) 2001 S. Karger AG, Basel.