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Published on: January 22, 2022
Tubal anastomosis after tubal sterilization: a review
Xavier Deffieux1, Michèle Morin Surroca, Erika Faivre
1Faculté de Médecine, Université Paris-Sud, Le Kremlin Bicêtre, F-94274 Paris, France. xavier.deffieux@abc.aphp.fr
Purpose:
To evaluate various techniques for restoring tubal patency after sterilisation.
Methods:
A search strategy was designed, and for each subject either thesaurus terms (MeSH descriptors) or terms from the title or summary were used.
Results:
Mean length of hospital stay following laparoscopy seems to be shorter in comparison with laparotomy (3.3 vs. 6.1 days, P < 0.05). Rate of conversion to laparotomy is 5%. Pregnancy rates observed are between 54 and 88% for laparotomy and 31-85% for laparoscopy. Mean time to conception was between 2 and 9.6 months. Most pregnancies occurred in the 2 years following restoration of tubal patency (cumulative conception rate 80% at 12 months). Young age (<35 years), type of ligature (rings), how recently the ligature was done (<8 years), the anastomosis site (in the middle of the tube) and a good length of remaining tube (>7 cm) are the factors that govern whether there can be good restoration of tubal patency. Ectopic pregnancy rates observed are between 1.7 and 12% for laparotomy and 0-7% for laparoscopy. There are no randomised or quasi-randomised studies comparing tubal anastomosis and in vitro fertilization.
Conclusions:
There are few good-quality controlled studies in this area. Results of restoration of tubal patency seem to be comparable, regardless of the route of approach (laparotomy or laparoscopy).
