Value Of Hysteroscopy And Laparoscopy In Diagnosis And Treatment Of Infertility With Strong Positive Result Of PPD Test

Objective: To observe the effect of hysteroscopy and laparoscopy in diagnosis and treatment of infertility patients with strong positive result of PPD test. Methods: 120 patients of infertility whose PPD test was positively diagnosed from J une 2005 to June 2013 were retrospectively analyzed.The patients were randomly divi ded into two groups based on the illness condition and patients’ willingness.60 patients for control group, who were treated by laparoscopic operation,and 60 patients for t reatment group,who were treated by hysteroscopy combined with laparoscopic operat ion. The study conducted a retrospective and statistical analysis on postoperative fertil ity, the types of infertility, and fertility time(12, 24 months later) by tw groups. Results:1. The patients of the treatment group were taken endometrial biopsies under hysteroscopy. 32 cases of uterine lesions and 16 patients of endometrial tuberculosis were found. 25 patients were found many nodes on the surface of tubal, uterine adnexa, intestine and peritoneum with inequality differences of size under laparoscopy. And 14 cases were confirmed by pathology after laparoscopic biopsies. The positive rate of biopsy was 23.33 %. The mild adhesion patients were treated by separation of the tubal under laparoscopy while other serious adhesion cases(7cases) were treated by tubal ligation.All 60 cases were received anti-tuberculosis chemotherapy before and after surgery.2. While in the control group, 21 patients were found many nodes on the surface of tubal, uterine adnexa, intestine and peritoneum with inequality differences of size under laparoscopy. And 11 cases were confirmed by pathology after laparoscopic biopsies. The positive rate of biopsy was 18.33 %. The mild adhesion patients were treated by separation of the tubal under laparoscopy while other serious adhesion cases(9cases) were treated by tubal ligation. 21 cases of uterine cavity diseases were found by color Doppler ultrasound examination, and 9 cases of endometrial tuberculosis were found by dilatation and curettage. All 60 cases were received anti-tuberculosis chemotherapy before and after surgery.3. Because of the higher pregnancy rate, the treatment group was better than the control group.Conclusion:In the early stage,there is few special symptom and examination in infertility patients with strong positive result of PPD test.The laparoscopy combined with hysteroscopic procedures are useful to for diagnosis and treatment of the disease in early stage. The earlier the diagnosis and treatment of the disease, the better the clinical effects and the prognosis of the patients.