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Microsurgical resection of nonocclusive salpingitis isthmica nodosa is beneficial
Khalid Awartani1, Peter F McComb
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada.
Objective:
To determine the effect of microsurgical resection and tubocornual anastomosis (TCA) of nonocclusive salpingitis isthmica nodosa (SIN) on fertility and risk for ectopic pregnancy (EP).
Design:
Prospective cohort.
Setting:
University-affiliated tertiary fertility clinic.
Patient(S):
Infertile women with hysterosalpingography evidence of SIN in patent fallopian tubes.
Intervention(S):
Microsurgical resection and TCA for nonocclusive SIN.
Main Outcome Measure(S):
Occurrence of IUP and EP after TCA; comparison of duration of infertility preceding TCA with time to intrauterine pregnancy (IUP) after TCA; and comparison of numbers of women who conceived an EP before and after TCA.
Result(S):
Twelve (46%) of the women had IUPs with a mean time to pregnancy of 10.5 months, which is significantly shorter than the preceding period of infertility. Three women experienced EPs after TCA, which is reduced compared with the number of women with an EP preceding the TCA.
Conclusion(S):
The significant decrease in time to conceive an IUP after surgery as compared with the duration of infertility before surgery and the apparent reduction in risk for EP after surgery demonstrate the benefit of TCA for resection of nonocclusive SIN.
