Association between history of abdominopelvic surgery and tubal pathology

Abstract

Background: Pelvic infection, unsafe abortion and previous laparatomy are risk factors for tubal infertility among Nigerian women. Reports on the relationship between these factors and tubal pathology seen on hysterosalpingography (HSG) from our environment have been few. Objective: To assess the prevalence of tubal occlusions among patients referred for HSG and examine the association between previous history of abdominopelvic surgery (including dilatation and curettage for abortion) and tubal occlusion. Methods: We studied one hundred and thirty women referred to the Radiology department for HSG because of infertility. HSG was performed during the early proliferative phase of the menstrual cycle. Information about type and duration of infertility, history of abdomino -pelvic surgery and history suggestive of previous pelvic infection, were obtained from the patients. The data obtained were analyzed using SPSS version 11.Test of association using the chi-square test was done where appropriate and differences were considered at p= 0.05. Results: Sixty one women had bilaterally patent tubes; tubal pathology was seen in sixty nine women. Significant association exits between tubal pathology and history of pelvic surgery p=0.01, pelvic infection p=0.02 and duration of infertility p=0.04. Conclusion: Previous surgery especially dilation and curettage, PID duration and type of infertility are associated with tubal pathology among Nigerian women. Creative methods of lowering the cost of diagnosis and management of tubal occlusion need to be instituted.

Hysterosalpingography findings among women presenting for gynecological imaging in Ado-Ekiti, South western Nigeria

“…Women tend to have a decline in fertility rate from the age of 35 years and according to a recent study involving 7172 women, older women are more likely to have tubal infertility than younger ones. 18 This study did not reveal any significant association between tubal occlusion and previous history of abdominal surgery in contrast to findings from another study done by Famurewa et al 19 There was also no relationship between bilateral tubal occlusion and type of infertility (primary or secondary).Bilateral tubal occlusion often implies a poor prognosis for possibility of natural conception. It is a major indication for In vitro fertilization (IVF) which is often beyond the financial capacity of most couples trying to achieve conception in a resource poor setting.…”

Infertility in the Moroccan population: major risk factors encountered in the reproductive health centre in Rabat

“…This is a very high frequency compared to the literature [ 4 ]. In a Nigerian study, 52.8% of women with a history suggestive of pelvic inflammatory disease had tubal pathology [ 15 ]. The proportion of previous sexually transmitted diseases in our patients might be underestimated for two reasons.…”

Assessment of Fallopian Tube Fimbria Patency With 4‐Dimensional Hysterosalpingo‐Contrast Sonography in Infertile Women

“…Previous pelvic infections, abortions, and pelvic surgery are common risk factors for fallopian tube–related infertility. Obstruction at the fallopian fimbria and surrounding pelvic adhesions induced by pelvic infection are the primary risk factors . Pelvic inflammatory disease may lead to edema, obstruction, and effusion at the fallopian fimbria, which can damage the ovum collection function of the tubal extremity and induce infertility .…”

“…Obstruction at the fallopian fimbria and surrounding pelvic adhesions induced by pelvic infection are the primary risk factors. 23 Pelvic inflammatory disease may lead to edema, obstruction, and effusion at the fallopian fimbria, which can damage the ovum collection function of the tubal extremity and induce infertility. 6 Although proximal obstructions can be treated in the clinic without surgery, the preferred treatments for obstructions at the distal tubal segment/fimbria and partial obstructions with pelvic adhesions include laparoscopic surgical procedures, such as tubal neosalpingostomy or resection and ligation of fallopian tubes with severe necrosis or edema.…”