Surgical procedures for inflammatory tubal disease

Microsurgical techniques using optical magnification and fine instruments in association with delicate tissue-handling yield improved success rates for tubal disease. This observation seems to be true despite the effects of tubal disease factors involving ovum pickup and transport. All data that seem to be comparable show nearly a twofold improvement in the success rate for distal and proximal disease and for salpingostomy, anastomosis, fimbriolysis, and salpingolysis. Of utmost importance are appropriate diagnosis and adequate evaluation of all fertility factors before recommendations are made for operation. Both the patient and her partner must be aware of the risks and the chances of success. Attempts should be made to determine all prognostic factors so that thorough discussion can be carried out and an informed patient is allowed to make the decision. Prospective studies should try to evaluate the specific factors that may be of importance in an attempt to improve the fertility of patients with diseased tubes.