Influence of Tubal Patency on Endometriosis Recurrence: A Retrospective Matched Case-control Study

STUDY OBJECTIVE: To study whether bilateral nonpatency of fallopian tubes is correlated with a lower recurrence rate of endometriosis. DESIGN: Retrospective 2:1 matched case-control study. SETTING: University hospital with a tertiary referral center for fertility and endometriosis surgery in Leuven, Belgium. PATIENTS: All patients undergoing complete laparoscopic excision of any revised system of the American Society of Reproductive Medicine-stage endometriosis between 2010 and 2014 (n = 896). INTERVENTIONS: Comparison between patients with bilateral nonpatent or absent fallopian tubes and matched controls with at least 1 patent fallopian tube. MEASUREMENTS AND MAIN RESULTS: Primary outcome was the recurrence rate, which was analyzed on 4 levels: overall recurrence, symptom recurrence, recurrence on imaging, and need for reintervention. Of 896 patients, 49 had bilateral nonpatent or absent fallopian tubes. These cases were compared with 98 matched controls with at least 1 patent fallopian tube. Symptoms recurred in 12.2% of the cases (n = 6) and 25.5% of the controls (n = 25) (p = .09). Recurrence was confirmed by imaging in 8% of the cases (n = 4) and 10.2% of the controls (n = 10) (p = .77). In 3 patients of the case group and 12 patients of the control group, there was a need for reintervention (p = .39). Within this subgroup, recurrence of endometriosis was histologically confirmed in none of the patients of the case group and 5 patients of the control group (p = .51). CONCLUSION: This study did not observe a statistically significant reduction in endometriosis recurrence in patients with bilateral occlusion/absence of the fallopian tubes after endometriosis surgery. A type II error may count for this result.