Tubal surgery. Report of 101 cases with special reference to the experience of the surgeon

A report is given of the results of tubal surgery in 101 cases selected from 851 sterility patients. The follow-up time was 3-10 years. Ordinary surgical technique was applied with the use of prednisolone and antibiotics but largely without the use of polyethylene tubing or other splints. Fourteen surgeons were involved. Since the most experienced surgeon operated on about 30% of the cases, an assessment of the effect of the surgeon's skill was possible. The patients are divided into groups with regard to type of operation, and the result is judged with regard to conception, live birth, ectopic pregnancy and abortion as well as with regard to patency. After salpingolysis the conception rate was 52%, and after salpingostomy 32%. There was, however, a gap between the conception rate and the live birth rate, especially for the salpingostomy cases. The live birth rate was more than twice as high after salpingolysis than after salpingostomy. The small lasting effect of cut adhesions is also demonstrated by the observation that combined unilateral or bilateral lysis did not interfere with the result after salpingostomy. Contrary to this, the patients conceived faster after salpingostomy than after salpingolysis. There was no difference between the results in the patients operated on by the most experienced surgeon and in those treated by the thirteen less skilled gynecologists.