Raw Dataset (VNOTES vs LS chromopertubation)

Background: As vaginal natural orifice transluminal endoscopic surgery (vNOTES) is gaining momentum and consolidating its position in minimally invasive surgery for various benign gynecologic conditions, we aimed to investigate the feasibility, acceptability and safety of vNOTES chromopertubation by comparing laparoscopic chromopertubation in women with suspected tubal factor or unexplained infertility Methods: Women who underwent vNOTES or laparoscopic chromopertubation between January 2022 and June 2024 were retrospectively reviewed. After applying exclusion criteria, a total of 58 eligible patients were identified and analyzed. The primary outcomes were surgical complications, overall satisfaction with the procedure and postoperative pain, while the secondary outcomes were the duration of the procedure and the participants' postoperative experience of sexual discomfort or pain during intercourse. Results: The women who underwent vNOTES had a significantly higher body-mass index (34.9±6.79 vs. 31.76±5.37, p=0.020). No complications occurred in either surgical arm. Compared to laparoscopy, vNOTES was associated with significantly lower 6- and 12-hour postoperative visual analogue scale (VAS) scores for pain (0.035 and <0.001, respectively), while there were no significant differences in analgesic requirements and the preoperative and postoperative 6-week Female Sexual Function Index (FSFI) pain domain scores were comparable. The changes in pre- and postoperative FSFI pain domain scores also showed no statistically significant difference between the groups (p=0.403). There were no differences in the satisfaction scores and the number of patients who were satisfied with the method (p=0.286 and 0.110 respectively). Conclusions: v-NOTES chromopertubation is an effective, safe and feasible alternative to laparoscopy for chromopertubation, which also increases operability in obese women and ultimately meets esthetic requirements with less postoperative pain and comparable effects on female sexual life. Larger, multicenter, prospective studies are needed to quantify and determine the safety and broad applicability of vNOTES chromopertubation.