Transvaginal hydrolaparoscopy and laparoscopy

Rachel Tros; Mianna van Kessel; Jur Oosterhuis; Walter Kuchenbecker; Marlies Bongers; Ben Willem Mol; Carolien Koks

doi:10.1016/j.rbmo.2019.10.011

Transvaginal hydrolaparoscopy and laparoscopy

Rachel Tros^*, Mianna van Kessel, Jur Oosterhuis, Walter Kuchenbecker, Marlies Bongers, Ben Willem Mol, Carolien Koks

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Research question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women.

Design: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities.

Results: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11(1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29.

Conclusion: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.

Original language	English
Pages (from-to)	105-112
Number of pages	8
Journal	Reproductive Biomedicine Online
Volume	40
Issue number	1
DOIs	https://doi.org/10.1016/j.rbmo.2019.10.011
Publication status	Published - Jan 2020

Keywords

Fertility
Laparoscopy
Patency tests
Transvaginal hydrolaparoscopy
Tubal pathology
HYSTEROSALPINGO-CONTRAST-SONOGRAPHY
TUBAL PATENCY
FOAM SONOGRAPHY
INFERTILITY
WOMEN
PATHOLOGY
ACCURACY
STANDARD

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10.1016/j.rbmo.2019.10.011

Cite this

@article{1461b4de9f744d82b8a40c1307e89428,

title = "Transvaginal hydrolaparoscopy and laparoscopy",

abstract = "Research question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women.Design: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities.Results: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11(1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29.Conclusion: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.",

keywords = "Fertility, Laparoscopy, Patency tests, Transvaginal hydrolaparoscopy, Tubal pathology, HYSTEROSALPINGO-CONTRAST-SONOGRAPHY, TUBAL PATENCY, FOAM SONOGRAPHY, INFERTILITY, WOMEN, PATHOLOGY, ACCURACY, STANDARD",

author = "Rachel Tros and {van Kessel}, Mianna and Jur Oosterhuis and Walter Kuchenbecker and Marlies Bongers and Mol, {Ben Willem} and Carolien Koks",

note = "Funding Information: We would like to thank SMJ van Kuijk, of the Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, for statistical support. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548); BWM reports consultancy for ObsEva, Merck KGaA and Guerbet. Funding Information: We would like to thank SMJ van Kuijk, of the Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, for statistical support. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548); BWM reports consultancy for ObsEva, Merck KGaA and Guerbet. Rachel Tros has been a gynaecologist at the Amsterdam UMC, location VUmc, since 2016. Alongside that, she is a PhD student under the supervision of Professor M Y Bongers of Maastricht University and Professor B W J Mol of Monash University, focusing on transvaginal hydrolaparoscopy. Key message Unlabelled box In this large retrospective study, a high concordance of findings between outpatient transvaginal hydrolaparoscopy (THL) and laparoscopy was found. This strengthens the hypothesis that outpatient THL is suitable to diagnose tubal pathology, and that laparoscopy should only be performed for therapeutic reasons. Publisher Copyright: {\textcopyright} 2019 Reproductive Healthcare Ltd.",

year = "2020",

month = jan,

doi = "10.1016/j.rbmo.2019.10.011",

language = "English",

volume = "40",

pages = "105--112",

journal = "Reproductive Biomedicine Online",

issn = "1472-6483",

publisher = "ELSEVIER SCI LTD",

number = "1",

}

TY - JOUR

T1 - Transvaginal hydrolaparoscopy and laparoscopy

AU - Tros, Rachel

AU - van Kessel, Mianna

AU - Oosterhuis, Jur

AU - Kuchenbecker, Walter

AU - Bongers, Marlies

AU - Mol, Ben Willem

AU - Koks, Carolien

N1 - Funding Information: We would like to thank SMJ van Kuijk, of the Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, for statistical support. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548); BWM reports consultancy for ObsEva, Merck KGaA and Guerbet. Funding Information: We would like to thank SMJ van Kuijk, of the Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, for statistical support. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548); BWM reports consultancy for ObsEva, Merck KGaA and Guerbet. Rachel Tros has been a gynaecologist at the Amsterdam UMC, location VUmc, since 2016. Alongside that, she is a PhD student under the supervision of Professor M Y Bongers of Maastricht University and Professor B W J Mol of Monash University, focusing on transvaginal hydrolaparoscopy. Key message Unlabelled box In this large retrospective study, a high concordance of findings between outpatient transvaginal hydrolaparoscopy (THL) and laparoscopy was found. This strengthens the hypothesis that outpatient THL is suitable to diagnose tubal pathology, and that laparoscopy should only be performed for therapeutic reasons. Publisher Copyright: © 2019 Reproductive Healthcare Ltd.

PY - 2020/1

Y1 - 2020/1

N2 - Research question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women.Design: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities.Results: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11(1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29.Conclusion: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.

AB - Research question: To evaluate the findings of outpatient transvaginal hydrolaparoscopy (THL) in comparison with diagnostic laparoscopy combined with chromopertubation in subfertile women.Design: In a retrospective study in four large teaching hospitals, all subfertile women who underwent a THL and a conventional laparoscopy as part of their fertility work-up in the period between 2000 and 2011 were studied. Findings at THL were compared with findings at diagnostic and therapeutic laparoscopies. Tubal occlusion, endometriosis and adhesions were defined as abnormalities.Results: Out of 1119 women, 1103 women underwent THL. A complete evaluation or incomplete but diagnostic procedure could be performed in 989 (89.7%) and 28 (2.5%), respectively. An incomplete non-diagnostic procedure was performed in 11(1.0%) women. Failure of THL occurred in 75 women (6.8%) and 40 of these women (3.6%) subsequently underwent laparoscopy. Laparoscopy was performed in a total of 126 patients with a median time interval of 7 weeks (interquartile range [IQR] 3-13 weeks). Of 64 patients who successfully underwent both THL and laparoscopy, concordant findings were found in 53 women and discordant results in 11 women, 6 of which were caused by tubal spasm. Sensitivity of THL in detecting abnormalities was 100% and specificity was 22.2%, with a likelihood ratio of 1.29.Conclusion: THL in an outpatient setting can detect anatomical abnormalities comparable to the more invasive reference standard diagnostic laparoscopy. If THL succeeds, there is no need to add a diagnostic laparoscopy in the work-up.

KW - Fertility

KW - Laparoscopy

KW - Patency tests

KW - Transvaginal hydrolaparoscopy

KW - Tubal pathology

KW - HYSTEROSALPINGO-CONTRAST-SONOGRAPHY

KW - TUBAL PATENCY

KW - FOAM SONOGRAPHY

KW - INFERTILITY

KW - WOMEN

KW - PATHOLOGY

KW - ACCURACY

KW - STANDARD

U2 - 10.1016/j.rbmo.2019.10.011

DO - 10.1016/j.rbmo.2019.10.011

M3 - Article

C2 - 31899124

SN - 1472-6483

VL - 40

SP - 105

EP - 112

JO - Reproductive Biomedicine Online

JF - Reproductive Biomedicine Online

IS - 1

ER -