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.

研究目标：旨在确定宫腔镜检查后子宫直肠陷凹（Douglas pouch）内液体量的增加是否可预测输卵管通畅性。研究设计：前瞻性临床队列研究，诊断准确性研究（加拿大工作组分类II-1）。研究环境：自2018年3月至2019年11月，在维也纳医科大学接受腹腔镜和宫腔镜手术的不孕症女性被邀请参与研究。主要结局指标为判断子宫直肠陷凹内液体量的增加是否反映单侧或双侧输卵管通畅。研究对象：115名不孕症女性。干预措施：在宫腔镜检查前后进行阴道超声检查，以检测子宫直肠陷凹内的液体，随后直接进行腹腔镜检查并使用染料通液。主要结局指标：通过宫腔镜前后子宫直肠陷凹液体量变化的缺失来检测双侧输卵管阻塞的准确性。