Neosalpingostomy for distal tubal obstruction: Prognostic factors and impact of surgical technique

Schlaff, William D.; Hassiakos, Dimitrios; Damewood, Marian D.; Rock, John A.

doi:10.1016/0020-7292(91)90798-a

Cited by 16 publications

(11 citation statements)

References 19 publications

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“…Pelvic adhesions did not impact the probability of recurrence in our study. These findings are consistent with several previous studies [14][15][16][17] but contrast with those of others [11,12,13,18]. Whereas the type of surgical procedure was not associated with recurrence of hydrosalpinx (laparoscopy versus laparotomy), presence of rugae on preoperative HSG significantly decreased the odds of recurrence.…”

Section: Discussionsupporting

confidence: 91%

Recurrence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population

Bayrak

Harp

Saadat

et al. 2006

J Assist Reprod Genet

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Purpose: The purpose of this study was to determine the recurrence rate of hydrosalpinges after cuff neosalpingostomy in poor prognosis candidates.Methods: Forty consecutive patients with hydrosalpinx treated with cuff neosalpingostomy were included. Main outcome measures were recurrence rate of hydrosalpinx after cuff neosalpingostomy, intrauterine and ectopic pregnancy rates.Results: Intraoperatively, the mean size of the hydrosalpinx was 1.9 ± 0.7 cm, and 77% of patients had evidence of pelvic adhesions. Recurrence of hydrosalpinx, whether unilateral or bilateral was 70% (28/40) per patient. Intrauterine and ectopic pregnancy rates were 5% (2/40) and 2.5% (1/40), with a total pregnancy rate of 7.5% (3/40).Conclusions: Most patients experience recurrence of hydrosalpinx after cuff neosalpingostomy, thus requiring additional surgery such as salpingectomy prior to in vitro fertilization (IVF). In a poor prognosis population, salpingectomy should be considered as the primary treatment for hydrosalpinx prior to IVF.

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Section: Discussionsupporting

confidence: 91%

Recurrence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population

Bayrak

Harp

Saadat

et al. 2006

J Assist Reprod Genet

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“…Moreover, there is still a significant pool of patients with restenosis occurring after traditional reconstruction procedures of Fallopian tubes. Admittedly, damage to the distal tubes is the leading cause for infertility in this group, which on rare occasions can be corrected by fimbrioplasty, fimbriolysis or neosalpingostomy [18]. Repeat microsurgical reconstruction of the proximal tube vies with transcervical tubal recanalization for the management of proximal or mid-tubal reocclusion.…”

Section: Discussionmentioning

confidence: 99%

“…However, for either procedure, the status of the distal tubes is of paramount importance. In the presence of minimal disease of the distal tubes, pregnancy rates of up to 80 % can be attained after correction of proximal tube reocclusion by microsurgical neosalpingostomy, while the rate drops to 16 % in the presence of severe disease of the distal tubes [18]. A distal tube diameter of greater than 2.5 cm and absence of rugae herald severe damage and hence dismal results.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes

Lang

1998

European Radiology

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The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes was evaluated in 29 patients who were referred for recanalization. Nineteen had strictures at the site of Fallopian tube reconstruction, and five had strictures, three had fistulae, and two had fistulae and strictures at the site of reversal surgery. A 0.014-inch highly flexible guidewire was passed through the obstruction into the ampullary segment, followed by a 1. 1-2.2 Fr bougie catheter to dilate the stricture. After recanalization, the distal tube was studied by selective salpingography. The method was technically successful in 17 of 19 patients with underlying inflammatory disease and resultant postoperative strictures. The tubes remained patent in 12 patients for a period of 12-48 months; three patients conceived, all delivering healthy babies. Significant disease of the distal tubes was present in seven patients. The technique succeeded in three of five patients with postoperative strictures following reversal surgery. One patient subsequently conceived and delivered a healthy baby. The technique failed in all five patients with fistulae complicating reversal surgery. Transcervical recanalization is thus recommended in the management of patients with postoperative strictures with underlying inflammatory obstruction and strictures complicating reversal surgery.

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“…High pregnancy rates of about 60% with EP rates of 6% have been reported in cases of the absence of peritoneal damage of serosa after the surgical procedure and a complete removal of adhesions with a good anatomical reconstruction of ovaries and fallopian tubes. EP rates increased up to 20% if at least one of these criteria was not fulfilled (Posaci et al, 1999;Lundroff et al, 1991) or if the tubal damage was severe (Lok et al, 2003;Boer-Meisel et al, 1986;Schlaff et al, 1990). For this reason, patients with dense adhesions and a severe tubal pathology are best referred to IVF.…”

Section: Peritubal Adhesiolysismentioning

confidence: 99%

Ectopic Pregnancy Following Reconstructive, Organ-Preserving Microsurgery in Tubal Infertility

Schippert¹,

Soergel²,

Garcia-Rocha³

2011

Ectopic Pregnancy - Modern Diagnosis and Management

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Neosalpingostomy for distal tubal obstruction: Prognostic factors and impact of surgical technique

Cited by 16 publications

References 19 publications

Recurrence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population

Recurrence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population

The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes

Ectopic Pregnancy Following Reconstructive, Organ-Preserving Microsurgery in Tubal Infertility

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