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A Watrelot

Publications and source records attributed to A Watrelot.

12 recordsLinked to original sources
PubMed2003

Is laparoscopy still the gold standard in infertility assessment? A comparison of fertiloscopy versus laparoscopy in infertility. Results of an international multicentre prospective trial: the 'FLY' (Fertiloscopy-LaparoscopY) study.

BACKGROUND: The aim of this prospective multicentre study was to compare the two endoscopic techniques of laparoscopy and fertiloscopy in routine evaluation of the pelvis in infertile women. METHODS: A total of 92 women was selected in 14 University Hospitals to undergo fertiloscopy followed by transabdominal laparoscopy by a team of two surgeons in each hospital. RESULTS: A high degree of concordance was observed between these two techniques, in that if fertiloscopy did not detect any abnormalities, this was also confirmed by laparoscopy. Discordance was observed in similar numbers of cases: eight after laparoscopy and nine after fertiloscopy. The diagnostic index for fertiloscopy and laparoscopy was calculated; sensitivity (86 and 87% respectively) and negative predictive value (64 and 67% respectively) were similar. The kappa index was also calculated for each of the six structures/regions (right/left tube; right/left ovary; peritoneum of pouch of Douglas; posterior uterus), and concordance (0.78 to 0.91) was considered almost complete. CONCLUSIONS: These results confirm fertiloscopy as a minimally invasive safe procedure that may be considered as an alternative to diagnostic laparoscopy in the routine assessment of women without clinical or ultrasound evidence of pelvic disease. On the basis of the additional advantages of fertiloscopy, namely salpingoscopy or microsalpingoscopy, it is considered that fertiloscopy could replace laparoscopy as a routine procedure in such women.

Adult↗
PubMed2002

Systematic salpingoscopy and microsalpingoscopy during fertiloscopy.

STUDY OBJECTIVE: To assess the feasibility of routine salpingoscopy and microsalpingoscopy by the vaginal route during fertiloscopy. DESIGN: Retrospective continuous series (Canadian Task Force classification II-2). SETTING: Private reproductive center. PATIENTS: Five hundred infertile women with no obvious pathology. INTERVENTIONS; Fertiloscopy with salpingoscopy followed by microsalpingoscopy. MEASUREMENTS AND MAIN RESULTS: Salpingoscopy was possible in 85% of women. In those with no pathology, only 8.2% had abnormal salpingoscopy but 37% had abnormal microsalpingoscopy. CONCLUSION: Fertiloscopy allows salpingoscopy and microsalpingoscopy to be performed in a reproducible and simple manner. Thus intratubal exploration should be integral to infertility assessment.

Adult↗
PubMed2001

Risk and outcome of bowel injury during transvaginal pelvic endoscopy.

OBJECTIVE: To determine the risk and outcome of bowel injury associated with new techniques of transvaginal pelvic endoscopy. DESIGN: A multinational retrospective survey based on confidential, self-reported cases. SETTING: Tertiary referral centers for infertility. PATIENT(S): Infertile patients without obvious pelvic pathology. INTERVENTION(S): Transvaginal hydrolaparoscopy and fertiloscopy. MAIN OUTCOME MEASURE(S): Full-thickness bowel injury. RESULT(S): Thirty-nine responders reported a total of 24 bowel injuries (0.65%) in 3667 procedures. After initial experience, the prevalence of bowel injury was 0.25%. All of the injuries were diagnosed during the procedure. Twenty-two (92%) of the cases were managed without consequences. CONCLUSION(S): The bowel lesion caused by the new techniques of transvaginal pelvic endoscopy tends to be minor and under strict conditions can be treated expectantly.

Female↗
PubMed2001

[Fertiloscopy].

Explore the source record for details and available documents.

Diagnostic Techniques, Obstetrical and Gynecologic↗
PubMed1999

Evaluation of the performance of fertiloscopy in 160 consecutive infertile patients with no obvious pathology.

We have defined fertiloscopy as the combination in one investigation of transvaginal hydropelviscopy, dye-test, optional salpingoscopy, and hysteroscopy, performed on an outpatient basis under local anaesthesia or neuroleptanalgesia. We have applied this approach in a routine manner to 160 infertile patients with no obvious pathology. Fertiloscopy was achieved in 154 patients (96.2%). In five patients visualization was not satisfactory because of technical problem or adhesions in the pouch of Douglas. We had one (0.6%) rectal injury, which was treated conservatively. Sixty patients (37.5%) had normal fertiloscopic examination. Endometriosis was discovered in 21 patients (13.1%) post-pelvic inflammatory disease (PID) lesions in 58 cases (36.2%), and subtle abnormalities in 15 cases (9.3%). Salpingoscopy was completed when post-PID lesions were encountered. In 39% of cases only partial examination was possible because of external tubal adhesions, but it was nevertheless sufficient to obtain a good view of the first one-third of the ampulla. In all, 74 patients (46.2%) were referred directly to in-vitro fertilization (IVF) procedures, and so avoided a further laparoscopy. Quality of imaging, accuracy of the pelvic examination in a physiological manner, and safety of the procedure are the main advantages of this minimally invasive technique. Selection of the patients for surgery is therefore enhanced, and indication for IVF is better balanced, avoiding the performance of extensive procedures in patients who should thus benefit from this less traumatic alternative.

Adult↗
PubMed1996

Is Reparative Tubo-Ovarian Surgery Obsolete?

With the availability of in vitro fertilization (IVF), reparative tubo-ovarian microsurgery is considered obsolete. In our institutions, salpingectomy has been performed for Mage score 4 and Brosen score 4 to 5 tubal occlusion. The results of reparative laparoscopic tubo-ovarian surgery (stages 1-3) are better for fimbrioplasty than for salpingoneostomy. The best result is for tubolysis and ovariolysis, often associated with fimbrioplasty. The procedure resulted in 27.7% intrauterine pregnancies and less than 10% ectopic pregnancies. The development of thin, atraumatic endoscopes will probably improve these rates and also reduce costs. We reevaluated reparative surgery after the failure of at least three cycles of IVF. With advances in salpingoscopy, the selection of patients improved for lesions of the ampulla. Women undergoing salpingoscopy had bifocal lesions, but also tubal occlusion with an unfavorable prognosis for the procedure's success. In women with hydrosalpinx, salpingectomy is supposed to improve the results of IVF. We reserve reparative and conservative surgery for women with good salpingoscopic score, which is probably one of the reasons for our encouraging results. For the proximal and isthmic part of the tube, the diagnosis remains difficult, despite the promising results of transcervical tuboscopy. The development of thin atraumatic endoscopes will probably continue to improve evaluation of tubal pathology and permit better patient selection for surgery.

Journal Article↗
PubMed1995

Clitoral blood flow increases following vaginal pressure stimulation.

The vascular responses of clitoral arteries to vaginal pressure stimulation in 10 volunteer women were evaluated by Doppler ultrasonography. Pressure stimulations (20-160 mm Hg) along the lower third of the vagina increased blood velocity and flow into clitoral arteries in 9 of the 10 women. The latency and duration of the Doppler responses ranged from 0.1 to 1.6 sec and from 3.2 to 9.5 sec, respectively, and the response was associated with a blood flow increase of 4 to 11 times the baseline prestimulation level. This response parallels that recorded in the cavernous arteries in men when a similar range of pressure stimulations are applied to the glans penis. Similar responses evoked in the male and female suggest a sexual synergy that may occur during intercourse in that such physiological responses and reflexes may be reciprocally reinforced.

Adult↗
PubMed1990

Gamete intra-fallopian transfer with cryopreserved donor semen following AID failure.

Results are presented of gamete intra-Fallopian transfer with cryopreserved donor semen in cases of male infertility with azoospermia or extreme oligozoospermia. The female partners had no detectable infertility problems and they had first received 10 cycles of intracervical AID without success. Forty-one GIFT cycles performed on 22 such patients gave an overall pregnancy rate of 26.8% (11/41). In 64% (9/14) of these cases, pregnancy occurred after the first GIFT attempt. From these results it is suggested that GIFT with donor semen may be a reasonable alternative after AID failure. The probable reasons for success of GIFT are discussed.

Adult↗
PubMed1981

[Prevention of peritoneal adhesions. An experimental study using noxytiolin (author's transl)].

Numerous procedures have been used to try to prevent peritoneal adhesions following operations. Noxytiolin has been used experimentally in the rat in a double blind trial on 3 series of 30 rats. A reliable procedure for making adhesions is said to be always reproducible. Comparing two control groups this study shows that statistically significantly this product lessens the number and seriousness of adhesions that can form, although it does not totally stop them developing.

Animals↗
PubMedDate not supplied

Ovary-oviduct distance and fertility experimental study, clinical application.

As the importance of ovary and fimbria relationships is well admitted in the phenomenon of oocyte captation, it has seemed interesting to the authors to try and evaluate, on an experimental plane, how fertility varies in function of ovary-fimbria distance, in view of possible therapeutic applications.

Animals↗