title: A comparison of treatment for bilateral fimbrial occlusion.
abstract: Eighteen patients with bilateral tubal occlusion were divided in an alternating fashion just prior to surgery into two groups for definitive treatment. One group consisted of nine women who underwent a two-stage procedure utilizing a Rock-Mulligan prosthesis; the other nine women underwent terminal salpingostomy utilizing microsurgical technique. Microsurgical technique was defined as the use of microcautery, lavage, and careful handling of tissues; the operating microscope was employed to achieve better visualization and hence better hemostasis and minimized tissue trauma. Both groups received pre-, intra-, and postoperative antibiotics, Decadron, and Phenergan. Hysterosalpingography revealed a patency rate of 89% in the hood group and in the group in which microsurgical technique was used. The term intrauterine pregnancy rates were 22.2% in the hood group (two of nine) and 44.4% in the group in which microsurgical technique was used (four of nine). In this small series there were no ectopic pregnancies or early pregnancy wastage. Subsequently, a series of 54 patients was treated by terminal salpingostomy with an over-all term intrauterine pregnancy rate of 26%. From this study, we conclude that the use of Rock-Mulligan hoods offers no distinct advantage over microsurgical salpingostomy, but has the disadvantage of requiring two surgical procedures.
mesh_terms: D003251:Constriction, Pathologic / Q000601:surgery / Q000628:therapy; D005184:Fallopian Tube Diseases / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000601:surgery / Q000628:therapy; D007813:Laparotomy; D008866:Microsurgery