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Semin Reprod Med 2011; 29(2): 095-100
DOI: 10.1055/s-0031-1272471
© Thieme Medical Publishers

Transvaginal Hydrolaparoscopy

Michelle Catenacci1 , Jeffrey M. Goldberg1
  • 1Section of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio
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Publication History

Publication Date:
24 March 2011 (online)

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ABSTRACT

Transvaginal hydrolaparoscopy (THL) is a modification of culdoscopy that can be used to evaluate the posterior uterus, pelvic sidewalls, and adnexae. Diagnostic THL can be done in the office under local anesthesia. Combined with diagnostic hysteroscopy and chromotubation, it can replace hysterosalpingography (HSG) as the first-line diagnostic test for the infertile woman. Studies have shown high patient tolerability with less pain reported postprocedure than with HSG. THL has been shown to have a high concordance with HSG for tubal patency, but THL diagnosed more intrauterine abnormalities as well as finding adhesions and endometriosis not visible with HSG. In addition, salpingoscopy may be performed during THL to assess the tubal lumen. THL also has a high concordance rate with laparoscopy when a complete evaluation is accomplished during THL. Complications of THL are uncommon and minor. Finally, operative procedures such as ovarian drilling, coagulation of endometriosis, lysis of adhesions, treatment of ovarian cysts, and salpingostomy may be performed via THL.

KEYWORDS

Transvaginal hydrolaparoscopy - fertiloscopy - salpingoscopy

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Jeffrey M GoldbergM.D. 

Professor and Head, Section of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology

Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195

Email: goldbej@ccf.org