Young G P, Ott D J, Chen M Y, Fayez J A, Gelfand D W
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1088.
J Reprod Med. 1993 Dec;38(12):924-8.
Medical records and postoperative hysterosalpingograms on 23 women following tubal surgery who failed to become pregnant within 2-28 months were reviewed. A total of 39 tubes were analyzed. The surgical indications were reversal of tubal ligation in 24 tubes and correction of tubal or perifimbrial disease in 15 tubes. Tubal ligation had been performed by a variety of methods. At surgery, tubal patency, as shown by chromotubation, was seen in 37 (95%) of 39 tubes. On postoperative hysterosalpingography, tubal spillage was present in 32 (82%) of 39 tubes. Radiographically, the tubes that spilled appeared normal except for occasional shortening after reversal of tubal ligation. The eventual pregnancy rate was 8 (35%) of 23 patients, with 7 intrauterine. Pregnancy occurred only in women under 35 years and was more likely in the group having reversal of tubal ligation. We conclude that among patients who do not initially become pregnant following tubal surgery for infertility, tubal patency is restored in most. During hysterosalpingography, tubes operated on may appear normal or shortened. On long-term follow-up, younger patients and those requiring tubal anastomosis only had a higher pregnancy rate.
对23名输卵管手术后2至28个月未能怀孕的女性的病历和术后子宫输卵管造影进行了回顾。共分析了39条输卵管。手术指征为24条输卵管的输卵管结扎逆转和15条输卵管的输卵管或输卵管伞周疾病矫正。输卵管结扎采用了多种方法。手术时，通过美蓝通液显示39条输卵管中有37条（95%）通畅。术后子宫输卵管造影显示，39条输卵管中有32条（82%）有造影剂外溢。影像学上，除输卵管结扎逆转后偶尔缩短外，有造影剂外溢的输卵管外观正常。最终妊娠率为23例患者中的8例（35%），其中7例为宫内妊娠。妊娠仅发生在35岁以下的女性中，且在输卵管结扎逆转组中更常见。我们得出结论，在因不孕进行输卵管手术后最初未怀孕的患者中，大多数患者的输卵管恢复了通畅。在子宫输卵管造影时，接受手术的输卵管可能外观正常或缩短。长期随访发现，年轻患者和仅需输卵管吻合术的患者妊娠率较高。
