| The role of severe adnexal disease in tubal reconstructive surgery. | |
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MedLine Citation:
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PMID: 6524258 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fifty two consecutive women underwent microsurgical reconstruction of the tubes. Thirty one percent conceived and 19% delivered live infants. Medical history suggestive of pelvic infection was obtained in 44% of the women. Fifty four percent had extensive, coarse and fibrous adhesions. Tubal reconstruction in these patients did not yield any pregnancies. Severity of the adnexal disease should be evaluated before attempted tubal reconstructive surgery. Women with severe adnexal damage should be referred to in vitro fertilization. The results of reconstructive tubal surgery performed without any preselection of patients were evaluated. 31% of the 52 consecutive women who underwent microsurgical reconstruction of the tubes conceived, and 19% delivered live infants. 4 women (8%) had spontaneous abortions -- 3 in the 1st trimester and 1 in the 2nd trimester. 2 (4%) women had ruptured tubal pregnancies and underwent salpingectomy. 20 patients (38%) had an unknown cause of tubal and peritoneal lesion. 10 (50%) conceived with 9 live birth infants and 1 spontaneous abortion. Reconstructive tubal surgery in patients with a known pelvic inflammatory disease and postpartum endometritis resulted in 3 (20%) pregnancies -- 2 spontaneous abortions and 1 tubal pregnancy. 44 (85%) women with peritubal and/or periovarian adhesions were analyzed according to the severity of their disease. 8 patients had tubal occlusion without peritoneal adhesions. 32 (62%) had grade III and IV adhesions. 3 patients with grade III adhesions conceived and none in grade IV. 2 tubal pregnancies occurred after lysis of adhesions and fimbrioplasty. Neosalpingostomy yielded 5 (22%) pregnancies and 3 (13%) live born infants. Repeated hysterosalpingograms were performed in 31 (60%) patients. In 15 (50%) the tubes were found to be reoccluded. 21 repeated diagnostic laparoscopies were performed. Of those women 10 had patent tubes and 3 of them conceived in 1 year. 11 patients had occluded tubes with grade III and IV adhesions. Repeated microsurgical reconstruction of the tubes was attempted in 2 patients, without any pregnancies in the follow up period of time. Severity of adnexal disease should be evaluated prior to attempted tubal reconstructive surgery. Women with severe adnexal damage should be referred to in vitro fertilization. |
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Authors:
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B Ismajovich; M Neudorfer; E Confino; A L Lidor; M P David |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta Europaea fertilitatis Volume: 15 ISSN: 0587-2421 ISO Abbreviation: Acta Eur. Fertil. Publication Date: 1984 Jul-Aug |
Date Detail:
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Created Date: 1985-03-05 Completed Date: 1985-03-05 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1300660 Medline TA: Acta Eur Fertil Country: ITALY |
Other Details:
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Languages: eng Pagination: 261-4 Citation Subset: IM; J |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Induced Adnexal Diseases / pathology* Endometriosis / complications Fallopian Tubes / surgery* Female Humans Infertility, Female / etiology, surgery* Microsurgery Pelvic Inflammatory Disease / complications Pregnancy |
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