Midtubal occlusion: etiology, management, and outcome.
OBJECTIVE
To assess the significance of pathological midtubal occlusion in infertility.


METHODS
Retrospective descriptive case review.


METHODS
Tertiary referral center.


METHODS
Sixteen women, 26 to 38 years of age presenting with infertility and diagnosed as having midtubal occlusion.


METHODS
Assessment of the etiology of the occlusive disease and yield of microsurgical tubotubal anastomosis.


METHODS
Histologic examination of occluded tubal segment and fertility outcome subsequent to anastomosis.


RESULTS
Occlusion was because of tuberculous salpingitis (n = 6), resolved tubal pregnancy (n = 3), endometriosis (n = 2), chronic inflammatory reaction (n = 1), tubal cyst (n = 1), intratubal adhesions (n = 1), infant hernia repair (n = 1), and calcification (n = 1). Of eight women (including the patient with tuberculous salpingitis) who underwent tubal anastomosis only for midtubal occlusion, three had subsequent term deliveries, two had tubal pregnancies, and three women did not conceive.


CONCLUSIONS
Midtubal occlusion of the tube because of an infectious process is rare. Excluding tuberculous salpingitis, microsurgical anastomosis yields satisfactory fertility, albeit with significant risk of ectopic pregnancy.
Urman
B
B
Department of Obstetrics and Gynecology, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
Gomel
V
V
McComb
P
P
Lee
N
N
D000328:Adult; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005187:Fallopian Tubes / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000209:etiology; D008866:Microsurgery; D012189:Retrospective Studies; D012488:Salpingitis / Q000175:diagnosis