Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology
Abstract
:1. Introduction
2. Materials and Methods
3. Results
Study Selection
4. Assessment of Tubal Patency Using the One-Step Procedure on Hysteroscopy and Laparoscopic Approaches
5. Hysterolaparoscopy (HL) Is a Diagnostic and Therapeutic Tool for Benign Uterine Pathology
6. How Can HL Manage Uterine Malformations?
7. The Complementary Role of Hysterolaparoscopy Procedures in the Management of Ovarian Abnormalities
8. Hysterolaparoscopy—A Therapeutic Challenge in the Management of Endometriosis
9. Discussion
10. Conclusions
11. Practice Key Points
- HL is a safe and effective therapeutic tool for benign uterine pathology and correctable uterine malformations.
- HL is a daycare procedure for the evaluation and treatment of female infertility.
- HL can diagnose undetectable imaging disorders in asymptomatic infertile patients or patients with mild symptoms.
- HL is a useful diagnostic method if the imaging techniques (3D-SIS ultrasound, MRI, or HyCoSy) are not accessible [114].
- HL is superior to HSG in diagnosing the tubal and uterine pathology but with similar accuracy to HyCoSy.
- HL is the first-line therapeutic option prior to ART in minimal/mild forms of endometriosis.
Author Contributions
Funding
Conflicts of Interest
Abbreviations
HL | hysterolaparoscopy |
ART | assisted reproduction techniques |
IVF | in vitro fertilization |
VCI | volume contrast imaging |
MRI | magnetic resonance imaging |
AMH | antimüllerian hormone |
UBESS | ultrasound-based endometriosis staging system |
RCT | randomized clinical trial |
CT | clinical trial |
SR | systematic review |
MA | meta-analysis |
PCOS | polycystic ovary syndrome |
EFI | endometriosis fertility index |
TVS | transvaginal sonography |
DIE | deep infiltrating endometriosis |
HSG | hysterosalpingography |
3D-SIS | 3D-saline infusion sonography |
HyCoSy | hysterosalpingo-contrast-sonography |
HyFoSy | hysterosalpingo-foam-sonography |
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Study | Uterine Pathology | Tubal Pathology | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Cervical Stenosis | Synechiae | Submucosal Fibroids | Polyps | Asherman Syndrome | Uterine Septum | Malformation | Atrophy | Others | Adhesions in the Tubal Ostium | |
Dawle [15] | 7 | 3 | 2 | 1 | ||||||
Neerja [16] | 58 | 20 | 20 | 5 | 25 | 22 | ||||
Firmal [17] | 1 * | 1 | 1 ** | |||||||
Puri [18] | 4 | 2 | ||||||||
Niranjan [19] | 6 | 5 | 3 | 2 | 2 | 8 | 2 | |||
Mehta [20] | 1 | 8 | 16 | 29 | 6 | |||||
Nandhini [21] | 1 | 1 | 4 | 1 | 1 | 3 | ||||
Kabadi [22] | 5 | 6 | 13 | |||||||
Avula [23] | 1 | 4 | 6 | 4 | 5 | 14 *** | ||||
Sharma [24] | 5 | 10 | 14 | |||||||
Ahmed [25] | 4 | 4 | 3 **** | |||||||
Sapneswar [26] | 4 | 5 | ||||||||
Shinde [27] | 4 | 7 | 1 | 2 | 8 | |||||
Wadadekar [28] | 2 | 1 | 4 | 1 | 1 | |||||
Ugboaja [29] | 95 | 37 | 46 | 34 | 14 ***** | |||||
Ekine [30] | 28 | 5 | 39 | 1 | ||||||
Ravikanth [31] | 4 | 1 | ||||||||
Kavitha [32] | 2 | 5 | 13 | 3 |
Study | Anomalies | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Uterine Pathology | Tubal Pathology | Ovarian Pathology | |||||||||||
Malformation | Endometriosis | Adhesions | Fibroids | Others | Tubal Blockage | Unilateral Tubal Block | Bilateral Tubal Block | Hydro-Salpinx | Tubo-Ovarian Mass | Endometriod Chistae | PCOS | Ovarian Mass | |
Dawle | 2 | 2 | 7 | 2 | 18 | 7 | 11 | 2 | |||||
Neerja | |||||||||||||
Firmal | 6 | 7 | 1 | 1 | 1 | ||||||||
Puri | 9 | 3 | 9 | 3 | 1 | 11 | 5 | ||||||
Niranjan | 2 | 2 | 5 | 4 | 5 | 4 | 2 | 4 | 8 | 11 | |||
Mehta | 3 | 41 | 29 * | 15 | 61 | 30 | 31 | 22 | |||||
Nandhini | 1 | 6 | 5 | 2 ** | 1 | 10 | 5 | 5 | 5 | 1 | 4 | 13 | |
Kabadi | 5 | 18 | 6 | 7 | 3 | 4 | 6 | 13 | |||||
Avula | 7 | 11 | 12 * | 5 | 32 | 14 | 18 | 48 | 7 | ||||
Sharma | 9 | 38 | 8 | 12 | 6 | 7 | 10 | 31 | |||||
Ahmed | 2 | 8 | 3 | 5 | 1 | 4 | |||||||
Agrawal | 67 | 34 | 78 | ||||||||||
Sapneswar | 9 | 5 | 9 | 3 | |||||||||
Ravikanth | 1 | 7 | 8 | 3 | 6 | 6 | 1 | ||||||
Kavitha G | 5 | 32 | 17 | 16 | 25 | ||||||||
Shinde | 9 | 12 | 4 | 9 (TB) | 6 | 4 | |||||||
Wadadekar | 2 | 3 | 15 | 18 | 4 | 2 | |||||||
Ugboaja | 19 | 91 | 130 | 84 | 46 | 96 | |||||||
Ekine | 80 | 13 | 20 |
Nr | Authors | Year | Inclusion Period | Study Design | Age | Nr | Type of Infertility | Hysteroscopy | Laparoscopy | Management | Pregnancy Rate | Conclusion | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
P | S | N | A | N | A | D | O | |||||||||
1 | Dawle | 2014 | 2011–2013 | PS | 18–40 | 100 | 100 | 0 | 83 | 13 | 66 | 34 | D | 21% |
| |
2 | Neerja | 2014 | NR | PS | 20–30 | 200 | 125 | 75 | 50 | 150 | 60 | 140 | D | O | 45.71% |
|
3 | Firmal | 2014 | 2009–2011 | PS | 27.6 (mean) | 30 | 24 | 6 | 28 | 2 | 19 | 11 | D | O | - |
|
4 | Puri | 2015 | NR | PS | 30 (mean) | 50 | 24 | 26 | 44 | 6 | 0 | 50 | D | O | 28.2% |
|
5 | Niranjan | 2016 | 2013–2015 | PS | 20–40 | 100 | 87 | 13 | 74 | 26 | 53 | 47 | D | O | 35–45% |
|
6 | Mehta | 2016 | 2013–2015 | PS | 28.8; 31.1 | 300 | 206 | 94 | 244 | 56 | 199 | 101 | D |
| ||
7 | Nandhini | 2016 | 2015–2016 | PS | 21–40 | 50 | 50 | 0 | 37 | 13 | 43 | 7 | D |
| ||
8 | Kabadi | 2016 | 2014–2015 | RS | 18–40 | 94 | 50 * | 16 | 43 | 17 | 44 | 47 | D | O |
| |
9 | Avula | 2017 | 2015–2016 | RS | 20–35 | 100 | 72 | 28 | 66 | 34 | 48 | 52 | D | O |
| |
10 | Sharma | 2017 | 2012–2015 | RS | 20–40 | 130 | 82 | 48 | 101 | 29 | 48 | 82 | D |
| ||
11 | Ahmed | 2017 | 2015–2016 | PS | 20–40 | 30 | 21 | 9 | 19 | 11 | 17 | 13 | D | O |
| |
12 | Agrawal | 2018 | 2016–2017 | PS | 19–35 (27.7) | 157 | 93 | 64 | 32 HL | 125 | D | O | 57.3% |
| ||
13 | Sapneswar | 2018 | NR | PS | 29.5 (mean) | 40 | 24 | 16 | 2 HL | 38 | D | O |
| |||
14 | Ravikanth | 2019 | NR | RS | 20–45 | 24 | 21 | 3 | 19 | 5 | NR | D | O |
| ||
15 | Kavitha G | 2019 | 2013–2018 | RS | 19–40 | 125 | 104 | 21 | 101 | 24 | 53 | 72 | D | O |
| |
16 | Shinde | 2019 | 2018–2019 | PS | 25–38 (33) | 100 | 50 | 50 | 80 | 20 | 57 | 43 | D | O |
| |
17 | Wadadekar | 2020 | 2019 | RS | 20–40 | 41 | 32 | 9 | 32 | 9 | 13 | 28 | D | O | 21.05% |
|
18 | Ugboaja | 2020 | NR | Cross-sectional survey | 35.6 mean | 230 | 106 | 124 | 78 | 152 | 59 | 171 | D | O |
| |
19 | Ekine | 2020 | 2010–2016 | RS | 25–46; (34.3) | 455 | 319 | 136 | NR | NR | 272 HL | 168 | D | O |
|
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Varlas, V.; Rhazi, Y.; Cloțea, E.; Borș, R.G.; Mirică, R.M.; Bacalbașa, N. Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology. J. Clin. Med. 2021, 10, 3749. https://doi.org/10.3390/jcm10163749
Varlas V, Rhazi Y, Cloțea E, Borș RG, Mirică RM, Bacalbașa N. Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology. Journal of Clinical Medicine. 2021; 10(16):3749. https://doi.org/10.3390/jcm10163749
Chicago/Turabian StyleVarlas, Valentin, Yassin Rhazi, Eliza Cloțea, Roxana Georgiana Borș, Radu Mihail Mirică, and Nicolae Bacalbașa. 2021. "Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology" Journal of Clinical Medicine 10, no. 16: 3749. https://doi.org/10.3390/jcm10163749