Microsurgical tubocornual anastomosis for occlusive cornual disease: reproducible results without the need for tubouterine implantation.

Microsurgical tubocornual anastomosis (TCA) and tubouterine implantation are the two primary operations used to treat proximal tubal occlusion (PTO). Tubouterine implantation usually has been reserved for cases of PTO in which the occlusion spans the entire intramural tubal segment. Yet TCA has proven to be more likely to lead to successful pregnancy than tubouterine implantation. In this series, all PTO was treated by TCA. The article compares the reproducibility of results of TCA by two different operators and establishes the usefulness of TCA in all cases of PTO without resort to tubouterine implantation. Fifteen of 26 women achieved viable intrauterine pregnancies, a rate virtually identical to that published earlier by Gomel. Microsurgical TCA can be used to the exclusion of tubouterine implantation to achieve higher pregnancy rates, despite complete intramural occlusion.