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An unusual complication of tubal anastomosis

Marcus W Jurema¹, Nikos P Vlahos

¹Division of Reproductive Endocrinology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.

Fertility and Sterility

|March 7, 2003

Abstract

Objective:

To report an unusual complication associated with the use of a long-term intrafallopian stent during microsurgical tubal anastomosis.

Design:

Case report.

Setting:

Tertiary academic center.

Patient(S):

A 36-year-old woman in whom an intrafallopian stent used during a sterilization reversal procedure could not be transcervically retrieved in the office.

Intervention(S):

Hysteroscopic evaluation for removal of intrafallopian stent, followed by operative laparoscopy for postoperative abdominal pain.

Main Outcome Measure(S):

Patient symptoms, potential for morbidity, and review of the literature.

Result(S):

Hysteroscopic view of the uterine cavity failed to identify the intrafallopian stent. Laporoscopic evaluation of postoperative abdominal pain revealed significant formation of pelvic and abdominal adhesions. The 2-0 nylon suture used as an intrafallopian stent was seen sitting freely on top of the liver serosa. Adhesiolysis and successful retrieval of the stent resolved the patient's symptoms.

Conclusion(S):

To our knowledge, this is the first report describing complete dislodgment and cephalad migration of an intrafallopian stent. Patient morbidity and health care costs may increase when long-term stents are used for sterilization reversal.

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