A Kuzmin1, V Linde. 1. Rostov Scientific Research Institute of Obstetrics and Pediatrics, Ministry of Health of the Russian Federation , Rostov-on-Don , Russia.
Abstract
STUDY OBJECTIVE: Tubal factor accounts for 25-30% of cases of female infertility. Laparoscopy "Gold Standard" for tubal evaluation. However, it is known that during the initial infection of the fallopian tube mucosal damage occurs, a condition which plays a decisive role in reproduction. MATERIALS AND METHODS: In this prospective randomized study, 468 infertile women with evidence of fallopian tube disease were included. In this, for 256 patients (group 1) afterlaparoscopic salpingolysis, salpingostomy we performed an additional step operation transcervical falloposcopy tubal dilatation (TFTD). 212 patients (group 2) produced only laparoscopic salpingolysis, salpingostomy. RESULTS: As a result, TFTD patency of the fallopian tubes for coaxial catheter was restored in 50 (78%) of 64 tubes with bilateral total occlusion, in 238 (93%) of 254 with partial occlusion of the bilateral, in 14 (58%) of 24 total unilateral occlusion and 26 (92%) of 28 with partial unilateral occlusion. Total number of pregnancies for one year in the first group of patients was 152 (59.3%), in the second 57 (27.1%), of which in the first group 147 -intrauterine pregnancies (57.4%) and in the second - 46 (21.7%). CONCLUSION:Falloposcopy surgeon provides good opportunities for the diagnosis and treatment of intralumen lesions. Significant increase in the frequency of uterine pregnancy in the case of an additional step - TFTD during salpingolysis, salpingostomy in patients with tubal factor infertility.
RCT Entities:
STUDY OBJECTIVE: Tubal factor accounts for 25-30% of cases of female infertility. Laparoscopy "Gold Standard" for tubal evaluation. However, it is known that during the initial infection of the fallopian tube mucosal damage occurs, a condition which plays a decisive role in reproduction. MATERIALS AND METHODS: In this prospective randomized study, 468 infertile women with evidence of fallopian tube disease were included. In this, for 256 patients (group 1) after laparoscopic salpingolysis, salpingostomy we performed an additional step operation transcervical falloposcopy tubal dilatation (TFTD). 212 patients (group 2) produced only laparoscopic salpingolysis, salpingostomy. RESULTS: As a result, TFTD patency of the fallopian tubes for coaxial catheter was restored in 50 (78%) of 64 tubes with bilateral total occlusion, in 238 (93%) of 254 with partial occlusion of the bilateral, in 14 (58%) of 24 total unilateral occlusion and 26 (92%) of 28 with partial unilateral occlusion. Total number of pregnancies for one year in the first group of patients was 152 (59.3%), in the second 57 (27.1%), of which in the first group 147 -intrauterine pregnancies (57.4%) and in the second - 46 (21.7%). CONCLUSION: Falloposcopy surgeon provides good opportunities for the diagnosis and treatment of intralumen lesions. Significant increase in the frequency of uterine pregnancy in the case of an additional step - TFTD during salpingolysis, salpingostomy in patients with tubal factor infertility.
Authors: Pedro Melo; Ektoras X Georgiou; Neil Johnson; Sabine F van Voorst; Annika Strandell; Ben Willem J Mol; Christian Becker; Ingrid E Granne Journal: Cochrane Database Syst Rev Date: 2020-10-22