Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology

Varlas, Valentin Nicolae; Rhazi, Yassin; Cloțea, Eliza; Borş, Roxana Georgiana; Mirică, Radu; Bacalbaşa, Nicolae

doi:10.3390/jcm10163749

Cited by 11 publications

(15 citation statements)

References 109 publications

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“…In our study, hysteroscopy was performed in 89% of women along with laparoscopy. The improved fertility performance and restoration by this combined hysteroscopy‐laparoscopy surgical treatment for endometriosis‐related infertility is one of the better options currently available, despite some limitations 25,26 . A previous study reported higher pregnancy rates (81.3%) and live birth rates (94.2%) after surgery and also indicated that surgical expertise and patient’s age play an important role in fertility performance rather than the endometriosis stage 25 .…”

Section: Discussionmentioning

confidence: 99%

“…The improved fertility performance and restoration by this combined hysteroscopy-laparoscopy surgical treatment for endometriosisrelated infertility is one of the better options currently available, despite some limitations. 25,26 A previous study reported higher pregnancy rates (81.3%) and live birth rates (94.2%) after surgery and also indicated that surgical expertise and patient's age play an important role in fertility performance rather than the endometriosis stage. 25 Ovarian endometriosis was found to be diagnosed preoperatively on ultrasonography in the majority of OMA cases, but other endometriotic lesions were undetected, which agreed with previous observations.…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics and surgical management of endometriosis‐associated infertility: A multicenter prospective cohort study

Bhurke

DasMahapatra

Balakrishnan³

et al. 2022

Intl J Gynecology & Obste

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Objective: To study clinical, surgical characteristics and the relationship between endometriosis lesion types and conception rate after surgery in infertile women with endometriosis.Methods: A prospective, multicenter cohort of 204 women (age 20-35 years) with endometriosis was followed up post-surgery between November 2017 and February 2020 at three tertiary-care hospitals.Results: Based on the severity of endometriosis lesion type, deep infiltrating endometriosis (DIE) (81/204, 39.7%) was the most common lesion; followed by ovarian endometriosis (OMA) (64/204, 31.4%), and superficial peritoneal endometriosis (SUP) (59/204, 28.9%). Endometriosis patients had a single lesion type (94/204, 46.1%), two lesion types (77/204, 37.7%), or three lesion types (33/204, 16.2%) with significant differences between regions (P < 0.001). Around 40% (37/95) of obese women had SUP (P = 0.003) whereas 78% (14/18) of underweight women had DIE (P < 0.001).Significant differences in mean Endometriosis Fertility Index scores between endometriosis lesion types and patients with one, two, and three types of lesions were observed (P < 0.001). The majority (22/32, 68.8%) of the women conceived naturally after the surgery. Half (16/32; 50%) of the women with a single lesion type conceived after the surgery; of which most (13/16, 81.2%) had SUP, followed by OMA (2/16, 12.5%), and DIE (1/16, 6.3%). Conclusion:Women with SUP and only one type of endometriotic lesion were more likely to conceive post-surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and surgical management of endometriosis‐associated infertility: A multicenter prospective cohort study

Bhurke

DasMahapatra

Balakrishnan³

et al. 2022

Intl J Gynecology & Obste

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“…When an analysis of the overall accuracy of HSG in detecting hydrosalpinx was performed, this gave a poor result (<90%); thus, HSG may not be the best of the tools in detecting hydrosalpinx. Varlas et al 24 in their systematic review has demonstrated the importance of see-and-treat advantage of HLD in the diagnosis of hydrosalpinx.…”

Section: Discussionmentioning

confidence: 99%

“…They, however, recognised the combined procedures of laparoscopy and hysteroscopy as the gold standard for utero-tubal assessment. 24 …”

Section: Discussionmentioning

confidence: 99%

Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation

et al. 2022

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Objective: To assess the accuracy of hysterosalpingography in diagnosis of uterine and/or tubal factor infertility, using hysterolaparoscopy with dye test as the gold standard with an implication for which test should be the first-line investigation. Methods: A prospective cross-sectional study of 96 women who underwent hysterosalpingography and hysterolaparoscopy with dye test. All women within reproductive age group with utero-tubal infertility who underwent both hysterosalpingography and hysterolaparoscopy with dye-test procedure were included. The outcome measures were proportions of tubal blockage and intrauterine pathology. Individual and overall mean accuracy were calculated for hysterosalpingography, using hysterolaparoscopy with dye test as the gold standard. Patient had procedure of hysterosalpingography first and both laparoscopic surgeons and patients were blinded to the outcome of hysterolaparoscopy with dye test until analysis. Statistical significance was set at p < 0.05. Results: Overall, 128 women were assessed for eligibility while 96 women finally completed the study. Hysterosalpingography demonstrated diagnostic accuracy of 77.8% (p < 0.001), 76.3% (p < 0.001) and 78.3% (p < 0.001) for right, left and bilateral tubal blockage, respectively. Overall accuracy of hysterosalpingography tubal factor assessment was 77.4 ± 0.8% (95% confidence interval = 76.5% to 78.4%). Hysterosalpingography showed an accuracy of 85.7%, 86.6% and 76.7% for right, left and bilateral hydrosalpinx, respectively, given overall diagnostic accuracy of 83.0 ± 5.1% (95% confidence interval = 77.9% to 88.1%). Overall accuracy of hysterosalpingography in diagnosing intrauterine pathology was 68.5 ± 9.8% (95% confidence interval = 53.9% to 83.1%). Conclusion: Hysterosalpingography detects tubal blockade and intrauterine pathology poorly compared to hysterolaparoscopy with dye test. Hysterosalpingography may face unpredictable clinical situations biased by technological error, leading to unsuccessful evaluation and uncertain diagnosis. Although the cost-effectiveness, risk of surgery or anaesthesia flaws hysterolaparoscopy with dye test. Hysterosalpingography should not be the first-line utero-tubal assessment tool rather hysterolaparoscopy with dye test.

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“…Hysteroscopy is a minimally invasive endoscopic surgical procedure recognized as a "gold standard" for the evaluation of the uterine cavity, for both diagnostic and therapeutic purposes [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Role of vocal distraction analgesia on pain management in the office hysteroscopy procedure: a randomized controlled studya

Palermo¹,

Serva²,

D’Alfonso³

et al. 2022

Ital J Gynaecol Obstet

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Objective. Hysteroscopy is a minimally invasive endoscopic surgical procedure recognized as a "gold standard" for the evaluation of the uterine cavity, for both diagnostic and therapeutic purposes. The possibility of performing hysteroscopy on an outpatient basis strictly depends on the patient's good compliance, which is a key prerequisite. Materials and Methods. Various methods of analgesia are reported in the Literature, one of them is vocal distraction. Occupying the mind with a distracting activity reduces pain sensations, not just by psychological conditioning. Results. Among patients who experienced verbal distraction analgesia, only 16% of them reported a high level of pain perception (VAS score > 4), while among untreated patients the percentage was 70%, 16% of which presented values within tolerable limits. Conclusions. Vocal distraction is thus an effective and easy-to-use analgesic method.

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Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology

Cited by 11 publications

References 109 publications

Clinical characteristics and surgical management of endometriosis‐associated infertility: A multicenter prospective cohort study

Clinical characteristics and surgical management of endometriosis‐associated infertility: A multicenter prospective cohort study

Correlation between hysterosalpingography diagnosis and final hysterolaparoscopy with dye-test diagnosis in women with utero-tubal infertility: A cross-sectional study of the implication for which test should be the first-line investigation

Role of vocal distraction analgesia on pain management in the office hysteroscopy procedure: a randomized controlled studya

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