Detection of hysteroscopic fluid in the pouch of Douglas: a prospective cohort study about the predictability of bilateral tubal occlusion
Study objective: To determine whether an increase in cul de sac (CDS) fluid after hysteroscopy is predictive of tubal patency. Design: Prospective clinical cohort study, diagnostic accuracy study (Canadian Task Force classification II-1). Setting: From March 2018 to November 2019, subfertile women undergoing laparoscopic and hysteroscopic surgery at the Medical University of Vienna were invited to participate. The primary outcome was determining whether an increase in fluid in the pouch of Douglas was reflective of unilateral or bilateral tubal patency. Patients: 115 subfertile women. Interventions: Vaginal sonography before and after hysteroscopy to detect fluid in the pouch of Douglas, directly followed by laparoscopy with chromopertubation. Main outcome measure(s): Accuracy of detecting a bilateral Fallopian tube occlusion via absence of a pre- to post-hysteroscopic fluid shift in the pouch of Douglas.