91 KB16 KB192920262003Reljič, MilanVlaisavljević, Veljkoletnik:72str. II-97-II-99številka:supl. 2COBISSID:1311551ISSN:1318-0347URN:URN:NBN:SI:doc-WZFFR5MHslSlovensko zdravniško društvoZdravniški vestnikDiagnostic techniques and proceduresDiagnostične metode in postopkidiagnostikaEndoscopyEndoskopijaginekologijaInfertility, femaleneplodnostNeplodnost, ženskaTransvaginalna hidrolaparoskopija| Transvaginal hydrolaparoscopy|Background. Transvaginal hydrolaparoscopy (THL), which is performed under local anesthesia is a new culoscopic technique for exploring the tubo-peritoneal infertility. The aim of paper is to present the experiences of foreign authors as well as our own experiences with this new technique. Methods and results. In the review of the literature we found out that the accuracy of THL is comparable to laparoscopy. THL diagnosis was correlated with that of laparoscopy in 82-93% of cases and no false positive observations were establish. The diagnostic accuracy of THL was 100%, in cases of complete pelvic evaluation. In evaluating tubal patency, it has been found that there was agreement between the THL and hysterosalpingography in 95% of cases, but THL was superior for the diagnosis of peritubal adhesions. Access to pouch of Douglas was successful in 90-96%, and both adnexae were fully visualized in 77-93% of women. In 0.65% of procedures extraperitoneal rectum injury was reported, which was also most common complication of THL. At our department 24 THL procedures were performed and our experiences are comparable with experiences of other authors. Conclusions. THL is a safe, accurate, minimal invasive and well tolerated diagnostic method which could replace HSG and/or laparoscopy in some cases but its role in infertility evaluation is not yet clearly definedIzhodišča. Transvaginalna hidrolaparoskopija (THL) je nova kuldoskopska metoda za ugotavljanje tubo-peritonealne neplodnosti, ki jo lahko izvedemo v lokalni anesteziji. Namen prispevka je predstaviti ugotovitve tujih avtorjev in naše izkušnje s to novo diagnostično metodo. Metode in rezultati. Pri pregledu literature smo ugotovili, da je zanesljivost THL primerljiva s klasično laparoskopijo. Izvid THL je bil skladen laparoskopskemu v 82-93%. Lažno pozitivnih izvidov THL niso ugotovili. Diagnostična zanesljivost THL je bila 100-odstotna, če je uspel pregled vseh struktur. Pri ugotavljanju prehodnosti jajcevodov so opazili skladnost izvidov THL z izvidi HSG v 95%, pri odkrivanju peritubarnih adhezij pa je bila THL bistveno zanesljivejša. Vstop v Douglasov prostor je uspel pri 90-96% in popoln pregled obeh adneksov pri 76,8-93,4% preiskovank. Pri 0,65% preiskav je prišlo do ekstraperitonealne poškodbe rektuma, ki je bil najpogostejši zaplet THL. Na našem oddelku smo naredili 24 THL in naše izkušnje so primerljive z izkušnjami tujih avtorjev. Zaključek. THL je varna, zanesljiva, minimalno invazivna in za bolnice sprejemljiva diagnostična metoda, ki lahko v določenih primerih nadomesti HSG in /ali laparoskopijo, vendar njena vloga v stopenjski obravnavi neplodnosti še ni dokončno opredeljenaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo