Transvaginal hydrolaparoscopy (THL) in diagnosing infertility.

INTRODUCTION: In recent years novel gynecological diagnostic methods have emerged. One of them is transvaginal hydrolaparoscopy (THL). This method allows endoscopic visualization of the organs within the women pelvis accessed through the posterior fornix of the vagina (Veress's needle was used) and with peritoneal distension by saline. OBJECTIVE: To evaluate a THL as a new technique for diagnosing pelvic pathology. METHODS AND RESULTS: In years 2002-2004, 56 patients underwent THL due to primary (40 cases) or secondary (16 cases) infertility (age 20-40). None of the patients had any history of previous pelvic surgery and all had normal findings on gynecological examination and vaginal sonography. The quality of the pelvic pictures was satisfactory in all cases. In the infertile group we observed in 42.8% cases of no macroscopic changes, in 57.2% some form of pelvic pathology ; 28.6% of demonstrated endometriosis, and 28.6% had tubal occlusion. There were no complications during or after the operation. CONCLUSIONS: THL is well-tolerated and accepted by the patients. THL is a safe, simple and inexpensive diagnostic method for pelvic pathology and infertility.