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Published on: October 18, 2024
Normal pregnancy after outpatient tubouterine implantation in patient with Adiana sterilization
Charles W Monteith1, Gary S Berger
1Chapel Hill Tubal Reversal Center, 109 Conner Drive, Suite 2200, Chapel Hill, North Carolina 27514, USA. drmonteith@tubal-reversal.net
Objective:
To demonstrate the feasibility of outpatient correction of Adiana proximal tubal occlusion by surgical implantation of the fallopian tubes.
Design:
Case study.
Setting:
Outpatient surgical center.
Patient(S):
A 36-year-old woman with a history of bilateral proximal tubal occlusion secondary to Adiana sterilization who desired surgical correction and natural conception.
Intervention(S):
Outpatient surgical correction of proximal Adiana tubal occlusion by use of a minilaparotomy to perform bilateral tubouterine implantation.
Main Outcome Measure(S):
Natural conception of pregnancy.
Result(S):
The patient underwent a successful outpatient bilateral tubouterine implantation to correct Adiana sterilization. The procedure was performed through a minilaparotomy abdominal incision by use of a posterior transfundal uterine incision to implant the isthmic sections of each tube into the uterine cavity. The patient's postoperative course was uncomplicated. Natural conceptions occurred at 6 and 9 months after surgery. The first pregnancy was of unknown location and aborted spontaneously. The second pregnancy was uncomplicated and was delivered at 39 weeks' gestation by elective cesarean delivery.
Conclusion(S):
Adiana hysteroscopic tubal occlusion can be surgically corrected in an outpatient setting through tubouterine implantation and this surgical technique can provide patients with an alternative to in vitro fertilization.
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