Contribution of the laparoscopy in case of radiological tubal abnormalities in infertile women. Experience in the gynecology department of yopougon university hospital in Abidjan (Ivory Coast)

Abstract

Objective: To report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women.
 Methodology: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 - December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.

Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.
 Conclusion: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.