Factors influencing the success of microsurgery for distal tubal occlusion

Summary Ninety-three infertile women with distal tubal occulsion were subjected to salpingostomy in 1982–1984. In 78 of them follow-up data were available for 2–5 years. Second look laparoscopy was performed in 47 patients at a median of 4 months postoperatively. It showed one or both tubes patent in 45 (96%). In the total series of 93 patients, 13% had live births, 7.5% spontaneous abortions, and 13% ectopic pregnancies. Severe adnexal adhesions and the extent of fimbrial damage found at operation or at second look laparoscopy were the most significant factors related to the poor outcome of microsurgery. Our experience suggests that cases with severe adhesions and poor tubal status should be primarily directed to in vitro fertilization program rather than to microsurgery. Similar content being viewed by others References Beyth Y, Bercovici B (1982) Evaluation of microsurgical approach to reconstructive surgery in 80 infertile patients. J Obstet Gynecol 2:237–243 Boer-Meisel ME, te Velde ER, Habbema JDF, Kardaun JPWF (1986) Predicting the pregnancy outcome in patients treated for hydrosalpinx: a prospective study. Fertil Steril 45:23–29 Donnez J, Casanas-Roux F (1986) Prognostic factors of fimbrial microsurgery. Fertil Steril 46:200–204 Edwards RG, Fishel SB, Cohen J, Fehilly CB, Purdy JM, Slater JM, Steptoe PC, Webster JM (1984) Factors influencing the success of in vitro fertilization for alleviating human infertility. J In Vitro Fert Embryo Transfer 1:3–19 Franzen C, Schlösser H-W (1982) Microsurgery and postinfectious tubal infertility. Fertil Steril 38:397–402 Garcia J, Acosta A, Andrews MC, Jones GS, Jones HW jr, Mantzavinos T, Meyer J, McDowell J, Sandow B, Veeck L, Whibley T, Wilkes C, Wright G jr (1984) In vitro fetilization in Norfolk, Virginia 1980–83. J In Vitro Fert Embryo Transfer 1:24–35 Gomel V (1978) Salpinostomy by microsurgery. Fertil Steril 29:380–387 Gomel V, Swolin K (1980) Salpingostomy: microsurgical technique and results. Clin Obstet Gynecol 23:1243–1258 Holtz G (1984) Prevention and management of peritoneal adhesions. Fertil Steril 41:497–507 Hulka JF, Omran K, Berger GS (1978) Classification of adnexal adhesions: a proposal and evaluation of its prognostic significance. Fertil Steril 30:661–665 Jansen RPS (1985) Failure of intraperitoneal adjuncts to improve the outcome of pelvic operations in young women. Am J Obstet Gynecol 153:363–371 Larsson B (1982) Late result of salpingostomy combined with salpingolysis and ovariolysis by electromicrosurgery in 54 women. Fertil Steril 37:156–160 Raj SG, Hulka JF (1982) Second-look laparoscopy in infertility surgery: therapeutic and prognostic value. Fertil Steril 38:325–329 Rock JA, Katayama KP, Martin EJ, Woodruff JD, Jones HW (1978) Factors influencing the success of salpingostomy techniques for distal fimbrial obstruction. Obstet Gynecol 52:591–596 Swolin K (1967) 50 Fertilitätsoperationen. Acta Obstet Gynecol Scand 46:219–267 Swolin K (1975) Electromicrosurgery and salpingostomy: long-term results. Am J Obstet Gynecol 121:418–419 Trimbos-Kemper TCM, Trimbos JB, van Hall EV (1985) Adhesion formation after tubal surgery: results of the eight-day laparoscopy in 188 patients. Fertil Steril 43:395–400 Wallach EE, Manara LR, Eisenberg E (1983) Experience with 143 cases of tubal surgery. Fertil Steril 39:609–617 Winston RML (1980) Microsurgery of the Fallopian tube: from fantasy to reality. Fertil Steril 34:521–530 Author information Authors and Affiliations Rights and permissions About this article Cite this article Laatikainen, T.J., Tenhunen, A.K., Venesmaa, P.K. et al. Factors influencing the success of microsurgery for distal tubal occlusion. Arch Gynecol Obstet 243, 101–106 (1988). https://doi.org/10.1007/BF00932975 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/BF00932975