title: Midtubal occlusion: etiology, management, and outcome.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Faculty of Medicine, Vancouver, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Urman
authors.forename: V
authors.initials: V
authors.lastname: Gomel
authors.forename: P
authors.initials: P
authors.lastname: McComb
authors.forename: N
authors.initials: N
authors.lastname: Lee
mesh_terms: 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