Grunert G M
Fertil Steril. 1981 Apr;35(4):406-8.
Hysterosalpingography (HSG), performed in the first 3 months after tubal ligation, has demonstrated a 1% to 2% incidence of tubal patency when initial operative errors have been excluded. In a group of 54 women, HSG was performed a mean of 4.8 years following sterilization; 9 women (16.7%) demonstrated spillage which was confirmed at laparoscopy in 7 of 8 women operated upon. No cases were due to initial surgical error. Delayed acquisition of tubal patency may explain late failure of tubal ligation, and the abnormal tubal lumen formed may be responsible for the increased percentage of ectopic pregnancies observed among sterilization failures. Ectopic pregnancy must be strongly considered in any failure of tubal ligation. In investigating the proximal tubal segment prior to consideration for tubal reconstruction, the possibility of a pre-existing or an iatrogenically formed fistula must be recalled which may predispose the patient to ectopic pregnancy.
输卵管结扎术后前3个月进行子宫输卵管造影（HSG）显示，排除初始手术失误后，输卵管通畅率为1%至2%。在一组54名女性中，HSG在绝育术后平均4.8年进行；9名女性（16.7%）显示有造影剂外溢，在接受手术的8名女性中有7名经腹腔镜检查证实。无病例是由初始手术失误导致的。输卵管通畅延迟可能解释输卵管结扎术的晚期失败，形成的异常输卵管腔可能是绝育失败中观察到的异位妊娠百分比增加的原因。对于任何输卵管结扎失败的情况，都必须高度考虑异位妊娠。在考虑输卵管重建之前检查输卵管近端时，必须想到存在既往或医源性形成的瘘管的可能性，这可能使患者易患异位妊娠。
