Second-look operative laparoscopy 1 year following reproductive surgery.
To evaluate the efficacy of a second-look operative laparoscopy following a reproductive surgery, a randomized study was conducted on women who failed to conceive 1 year following terminal salpingostomy or following salpingo-ovariolysis by laparotomy. There is no significant difference in the cumulative probability of pregnancy at 12, 24, and 36 months follow-up between women who underwent second-look operative laparoscopy 1 year after salpingo-ovariolysis (27%, 67%, and 67%) and women who were continued to be observed expectantly (27%, 45%, and 52%, respectively). The cumulative probability of conception at 12, 24, and 36 months follow-up in women who underwent second-look laparoscopy 1 year after salpingostomy was 6%, 18%, and 18% and in women who were observed expectantly was 5%, 21%, and 27%, respectively (P = no significant). The incidence of ectopic pregnancy which was high (about one-half of patients who conceived) was also not affected by this procedure. This study suggests that second-look operative laparoscopy 1 year after terminal salpingostomy or salpingo-ovariolysis does not increase the pregnancy rate or decrease the incidence of ectopic pregnancy. Women who fail to conceive 1 year after a reproductive surgery still maintain some of their reproductive potential, but the risk of having an ectopic pregnancy is high.
Tulandi
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Fertility Center, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Falcone
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Kafka
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D000328:Adult; D002986:Clinical Trials as Topic; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy; D007813:Laparotomy; D010053:Ovary / Q000601:surgery*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D011336:Probability; D011897:Random Allocation; D012086:Reoperation; D012307:Risk Factors; D012489:Salpingostomy; D013997:Time Factors