[Effect of the etiology of sterility on the results of tubal microsurgery].

The authors have carried out a prospective study from the 1 January 1977 to the 31 December 1981 on 168 women, 89.3% of whom (150/168) had pure distal tubal microsurgery and 10.7% (18/168) had mixed surgery. The results were studied in relationship to the aetiological reason for tubal sterility, which was: salpingitis in 60 cases = 35.7%; appendicitis in 23 cases = 13.7%, endometriosis in 29 cases = 17.3%, termination of pregnancy in 22 cases = 13.1% and unknown causes in 34 cases = 20.2%. The figures for intra-uterine pregnancies were 32.74% after 24 months using a classical method of determining it and 31% using an actuarial method. There was a significant difference between endometriosis and the four other aetiologies. These latter could not be differentiated between one another. The level of ectopic pregnancies was 5.3% at 24 months, or 6.3% using an actuarial method. It was higher after endometriosis. It would therefore appear from the results of this study that endometriosis seems to be poor from a prognostic point of view when compared with the other aetiological causes and the results shown in the literature. Finally the authors discuss in cases of endometriosis whether it is correct to carry out a second operation after the first or to resort to the other possibility, namely in vitro fertilisation.