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Article
October 25, 1958

SURGICAL MANAGEMENT OF THE TUBAL FACTOR IN INFERTILITY

Author Affiliations

Menlo Park, Calif.

Instructor, Obstetrics and Gynecology, Stanford University School of Medicine, San Francisco.

JAMA. 1958;168(8):991-994. doi:10.1001/jama.1958.03000080007002
Abstract

Sixty-nine patients with infertility due to tubal occlusion were treated by salpingolysis, salpingostomy at the fimbria, resection of the occ/uded part with reanastomosis, and reimplantation of the tube (when blocked near the cornu uteri) into the uterus. In all procedures, other than salpingolysis, the use of polyethylene tubing as a splint, to be left in place as long as three months, was an important part of the technique. Eighteen pregnancies (26 %) have occurred after operation in the 69 women of this series. The use of polyethylene tubing has resulted in a greater frequency of tubal patency. However, in spite of patency, pregnancy does not occur often if the tubal wall has been badly damaged. Pregnancy will occur most often when damage is limited to peritubal adhesions. Diagnosis of peritubal adhesions may fail unless culdoscopy is utilized in women whose infertility is unexplained after the completion of the usual studies. Culdoscopy was necessary for diagnosis in 17 of the 35 women in this series with peritubal adhesions due to pelvic inflammatory disease or endometriosis. Forty per cent of the 35 women treated by salpingolysis have become pregnant.

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