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 women. Design, Retrospective, descriptive feasibility study (Canadian Task Force classification II-2). Setting. Office in an infertility center. Patients, One hundred fifty-seven continuous women with primary or secondary subfertility. Intervention, Under local anesthesia, a Veress needle-cannula system was inserted into the posterior fornix with peritoneal distention by saline. Measurements and Main Results. Access was achieved in 95% of patients. In 58.5% the findings were normal and in 28% an explorative or operative laparoscopy 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 subfertile women.