Complex one-stop investigation of infertility: transvaginal hydrolaparoscopy

Abstract

One of the intensively discussed topics recently is investigation of infertile patients. A subject of particular interest is a new technique -transvaginal hydrolaparoscopy (TVHL), which has already found its place amongst other methods of infertility exploration. Transvaginal hydrolaparoscopy allows atraumatic investigation of reproductive organs in physiologic conditions, in ambulatory settings. Significant, for clinical practice, is the possibility of a combination of transvaginal hydrolaparoscopy with other methods of investigation -sonohysterosalpinogography, hysteroscopy and salpingoscopy, which make possible integrated exploration of the reproductive system. Instillation of saline into the pelvic cavity through uterine tubes (or through puncture needle if needed) under ultrasonographic control and exposition of posterior fornix, allows better orientation in the pouch of Douglas, complex assessment of reproductive organs and determination of advisability of pelvioscopy -the relatively invasive technique as well as thorough control of the safe access to the pouch of Douglas.

The role and contribution of transvaginal endoscopy to diagnostics and treatment of infertility

“…Утвр ђе но је и да је ТВЛ су пер и ор ни ји у при ка зу ту бо о ва ри јал них струк ту ра, да је про сеч но тра ја ње про це ду ре све га осам ми ну та и по твр ђе но да је ово си гу р на, ре про ду ци бил на ме то да ко ја пру жа од лич ну про це ну струк ту ра ма ле кар ли це у утвр ђи ва њу ин фер ти ли те та не по зна тог по ре кла [10]. Све сту ди је су по ка за ле да, уко ли ко се при ме ном ТВЛ до био па то ло шки на лаз, ни је би ло нор мал них на ла за при ме ном ла па ро ско пи је [11].…”

Transvaginal access: a safe technique for tubo-ovarian exploration in infertility? Review of the literature

“…With this method, no bowel injury occurred in a consecutive series of 460 patients. Mgaloblishvili et al [22] proposed to proceed first with hysteroscopy using saline for partial filling of the pouch of Douglas, followed by sonohysterosalpingography to clearly visualize and assess the fornix and the pouch of Douglas. Cancellation for transvaginal pelvic endoscopy included:…”