Emergency versus elective microsurgery

During a 30-months period, a total of 148 microsurgical gynecological operations were performed in our department. We divided these operations into two groups: Emergency microsurgical operations, where microsurgical technique is used in urgent cases for preservation of fertility potential, and elective microsurgical operations, performed for restoration of fertility. We compared the two groups with regard to their inherent characteristics and differences in therapeutic and prognostic approach towards them. The results of our comparison show, that these two groups having in common only the microsurgical approach, are different from each other in the following points: The average age of the emergency microsurgery group was younger since it contained also prefertility cases; the timing of operations in the elective group was always in the proliferative phase of the menstrual cycle; antibiotics were given pre-, intra and postoperatively only in the elective group; corticosteroids were given intra- and postoperatively only in the elective group; the average number of different operative procedures performed during one operation was higher in the restorative group; desire for pregnancy was always present in the restorative and inconstantly in the preservative group; results of the operations regarding intrauterine pregnancy can be evaluated only for the elective, and not for the emergency group. Psychological evaluation of cases can be performed in the elective and not in the emergency group. Because of these differences, a division of microsurgical operations into elective and emergency microsurgery seems justified and valuable to us.