title: Utero-ovarian morphology and blood flow after tubal ligation by the Pomeroy technique.
abstract: OBJECTIVE
  The objectives of this study were to evaluate ovarian sonographic morphology and pelvic blood flow in patients who had undergone bilateral tubal ligation by the Pomeroy technique.
  
  
  METHODS
  Twenty women who had undergone bilateral tubal ligation during cesarean section by the Pomeroy techniques were compared to 20 matched controls who had undergone cesarean section alone. Ovarian morphology as well as ovarian and uterine pulsatility index (PI), resistance index and peak systolic velocity were evaluated using transvaginal sonography and Doppler velocimetry.
  
  
  RESULTS
  Patients post tubal ligation by the Pomeroy technique were found to have a significantly higher rate of polycystic appearance of the ovaries (60% vs. 5%; p < 0.005). Six patients (30%) had post tubal ligation symptoms, as compared to none of the controls. Five of the six symptomatic tubal ligation patients (83%) had ovarian polycystic appearance, which was not significantly different than asymptomatic patients. Ovarian artery PI was significantly higher in symptomatic patients (2.7 +/- 1.9) compared to asymptomatic patients (1.5 +/- 0.9) (p < 0.05).
  
  
  CONCLUSIONS
  We therefore conclude that patients post bilateral tubal ligation by the Pomeroy technique may acquire an ovarian polycystic appearance and increased ovarian PI, which may be associated with a tendency to develop post tubal ligation symptoms.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah University Hospital, Jerusalem, Israel. revel@md.huji.ac.il
authors.forename: Ariel
authors.initials: A
authors.lastname: Revel
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
authors.forename: Simcha
authors.initials: S
authors.lastname: Yagel
authors.forename: Michel
authors.initials: M
authors.lastname: Nadjari
mesh_terms: D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods; D010053:Ovary / Q000098:blood supply* / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology; D011673:Pulsatile Flow; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods; D014599:Uterus / Q000098:blood supply* / Q000473:pathology; D014655:Vascular Resistance