Khouri, Amena;
(2004)
Evaluation of diagnostic culdoscopy in women with infertility.
Doctoral thesis (Ph.D.), University College London (United Kingdom).
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Abstract
Assessments of infertile couples involve several investigations including semen analysis, assessment of ovulation and assessment of pelvic viscera. Diagnostic laparoscopy is considered the gold standard for investigating pelvic pathology in infertile women. Although it is generally safe, it involves surgery and requires general anesthesia and the risk of complications. Our aim was to evaluate a new method of investigating pelvic pathology in infertile women and to determine its feasibility and acceptability as an outpatient investigation. Culdoscopy was introduced first by Decker and Cherry in 1944, but it did not advance after 1960's as the technology of laparoscopy was continuously improving and so it was the preferred approach by most gynaecologists. Culdoscopy was reintroduced recently after it has been modified for application to modern practice of gynaecology under the name of transvaginal hydrolaparoscopy (THL). The One-Stop Fertility Clinic was started in the Royal Free Hospital in 2000 a single out-patient visit where pelvic ultrasound, hysteroscopy and culdoscopy are performed and the results and management plan were available immediately was acceptable to most patients.The diagnostic accuracy of culdoscopy was assessed and compared to standard laparoscopy. The comparison of pelvic findings was done in the same patient by two different operators blind to each other. The acceptability of out-patient culdoscopy under local anesthesia was compared with in-patient culdoscopy under light sedation combined with local anesthesia and with in-patient laparoscopy under general anesthesia. Also the comparison was made in terms of recovery and return to work between the three groups of patients. The costs of out-patient culdoscopy was compared to in-patient laparoscopy and showed that although there were other factors which may influence the costs of out-patient culdoscopy, it did provide noticeable savings to the healthcare.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D. |
| Title: | Evaluation of diagnostic culdoscopy in women with infertility |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. |
| Keywords: | (UMI)AAI10014341; Health and environmental sciences; Hydrolaparoscopy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10102842 |
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