Abstract
Background: Infertility is a global problem, but the highest prevalence is in low resource countries, particularly in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Methods: A descriptive review of complete medical records of 208 women who underwent laparoscopy at the Gynaecology Unit of Yaounde General Hospital from December 2007 to December 2012. Results: Two hundred and eight women were enrolled in this study. Mean age was 32.6 ± 11.25 years. Infertility was secondary in 71.6% of cases; 125 (60.1%) women were married and 116 (55.8%) had a positive serology of Chlamydia trachomatis infection. The most frequent findings during diagnostic laparoscopy were: pelvic adhesions (83.7%), hydrosalpinx (21.6%), pyosalpinx (4.8%), perihepatic adhesions (25.5%), uterine fibromas (22.6%), pelvic endometriosis (13%) and ovarian abnormalities (10.1%). The surgical procedures during laparoscopy were: adhesiolysis (79.7%), tuboplasty (35.0%), salpingectomy (8.2%), ovarian cystectomy (5.8%) and myomectomy (1.9%). Three (1.4%) cases of uterine perforation and 1 (0.5%) case of laparoscopy conversion to laparotomy were observed. Conclusion: Diagnostic laparoscopy revealed that tubal lesions and pelvic adhesions were still the major causes of female infertility in developing countries. Adhesiolysis and tuboplasty were the most frequently performed surgical procedures during laparoscopy. Therefore, training in endoscopic surgery should be regarded as an important issue in developing countries.
Highlights
Infertility is a global problem, but the highest prevalence is in low resource countries, in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause
We reviewed in this study 208 cases of laparoscopy at the Yaoundé General Hospital indicated for female infertility
Our result is high than 40.6% of pelvic adhesions reported by Mbaye et al among women who underwent laparoscopy at Dakar University Hospital and 33% of pelvic adhesions reported by Jain et al among women who underwent laparoscopy for infertility in India [5] [13]
Summary
Infertility is a global problem, but the highest prevalence is in low resource countries, in sub-Saharan Africa where tubal damage following pelvic infection is the commonest cause. Objectives: This study aimed to assess contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting. Previous studies in low resource countries reported that infertility was the main indication for gynaecological laparoscopy [5]-[7]. Operative procedures, such as lysis of adhesions, ablation of endometriosis, tuboplasty and salpingectomy for hydrosalpinx or pyosalpinx at the time of laparoscopy can enhance conception, naturally or with intra uterine insemination or in vitro fertilization [3] [8]. The aim of this study is to evaluate the contribution of laparoscopy as a diagnostic and therapeutic tool in infertile women in our setting
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