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Abstract

Transvaginal hydrolaparoscopy is such an alternative procedure to hysterosalpingography and laparoscopy, allowing direct visualization of the female peritoneal cavity. Although transvaginal hydrolaparoscopy has an extensive history of use in Europe, it is rarely conducted in Turkey. This is probably because of the lack of knowledge and experience on transvaginal hydrolaparoscopy. No abdominal incision was required, and the procedure can be accomplished in an office setting with less pain than hysterosalpingography procedure. In contrast to traditional hysterosalpingography for evaluation of tubal patency, No abdominal incision was required, and the procedure can be accomplished in an office setting with less pain than HSG procedure. In contrast to traditional HSG for evaluation of tubal patency, transvaginal hydrolaparoscopy additionally permits direct inspection of the tubal mucosa. Transvaginal hydrolaparoscopy can also be performed in conjunction with chromopertubation, salpingoscopy, microsalpingoscopy, and hysteroscopy. The operative port on the vaginal trocar also allows insertion of a single operative instrument for adhesiolysis, ablation of endometriosis, and ovaryan drilling. The risks associated with transvaginal hydrolaparoscopy range from bleeding to more adverse outcomes, rectal puncturing. The occurrence of rectal injury was about 0.6%. This complication was succesfully managed with conservative treatment consisting of prophylactic antibiotics for 2 days following laparoscopic confirmation of peritoneal integrity. Transvaginal hydrolaparoscopy appears to be a relatively safe alternative to hysterosalpingography and laparoscopy for evaluation of tubal patency and pelvic pathology

Keywords

• Infertility, tubal factor, endoscopy

İnfertilite Tanısında Transvajinal Hidrolaparoskopi Kullanımı

Abstract

Transvajinal hidrolaparoskopi,  histerosalpingografi  ve laparoskopiye alternatif olarak kadın periton boşluğunun direk olarak gözlenmesine izin veren bir yöntemdir. Transvajinal hydrolaparoskopi Avrupa'da yaygın olarak kullanılmasına rağmen Türkiye’de nadiren yapılmaktadır. Bu da muhtemelen transvajinal hidrolaparoskopi ile ilgili bilgi ve deneyim eksikliğine bağlıdır. Bu yöntem hiçbir karın kesisine ihtiyaç olmadan, ofis şartlarında yapılabilen, histerosalpingografi işlemine göre daha az ağrılı olarak yapılabilmektedir. Tubal açıklık değerlendirilmesinde geleneksel olarak kullanılan histerosalpingografinin aksine transvajinal hidrolaparoskopi ek olarak tubal mukazanın direk olarak gözlenmesine de izin vermektedir. ransvajinal hidrolaparoskopi ile birlikte kromopertubasyon, salpingoskopi, mikrosalpingoskopi ve histereskopi yapılabilmektedir. Vajinal trokar üzerindeki operatif port ile adezyolizis, endometriyozis ablazyonu ve ovaryan drilling yapılabilmektedir.  Transvajinal hidrolaparoskopiile ilişkili riskler olarak kanama ve daha ileri olarak rektal delinme olabilmektedir. Rektal zedelenme %0.6 civarında olmaktadır. Bu komplikasyon konservatif olarak 2 gün antibiyoterapi ve ertesinde laparoskopi ile peritoneal devamlılığın kontrolü ile başarılı bir şekilde yönetilmektedir. Transvajinal hidrolaparoskopi, histerosalpingografi ve laparoskopiye göre tubal açıklık ve patolojinin değerlendirilmesinde nispeten güvenilir bir alternatif olarak gözükmektedir.

Anahtar Kelimeler: İnfertilite; tubal faktör; endoskopi

Keywords

• İnfertilite, tubal faktör, endoskopi

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