Mecke H, Lehmann-Willenbrock E, Lesoine B, Kaya S, Ibrahim M, Semm K
Coburtshilflich-Gynäkologische Abteilung Auguste-Viktoria-Krankenhaus Berlin.
Geburtshilfe Frauenheilkd. 1993 Oct;53(10):693-9. doi: 10.1055/s-2007-1023611.
In 1988 and 1989 176 patients underwent pelviscopy at the Kiel University Hospital of Gynaecology for primary or secondary sterility of at least 12 months duration. 120 patients (68%) filled in a questionnaire on the therapeutic results after 2 to 3 years. Following peripheral salpingostomy in 18 patient, an intrauterine pregnancy developed in 22% of these cases, while an ectopic pregnancy occurred in 11% of the cases. After fimbrioplasty in 37 cases, the intrauterine pregnancy rate amounted to 43%, whereas the rate was 50% following salpingoovariolysis. 4 patients with a subserous or intramural myoma, measuring 2.5 to 8 cm in diameter, but no other pathological signs of disturbed fertility, became pregnant after enucleation of the myoma. 2 patients delivered at full term, the other two miscarried. 5 out of a total of 10 patients became pregnant after endometriosis foci had been coagulated or endometriomas enucleated. In these cases, the adnexa did not require additional surgical treatment. Pelviscopy revealed an untreatable intratubal block in 9 cases. 10 patients could not be included in the study, either because of a successful in vitro fertilisation or a pregnancy following heterologous insemination or because a hysterectomy or tubectomy had been performed in the meantime. In cases, where inspection under magnification had shown at least one non-pathological adnexa and tubal patency of at least one of the tubes, 35% of the patients conceived after pelviscopy and chromopertubation within the follow-up period. The therapeutic action of the chromopertubation and the psychological effect of finding no pathological signs during the genital examination remains speculative.(ABSTRACT TRUNCATED AT 250 WORDS)
1988年和1989年,176例患者因原发性或继发性不孕至少12个月,在基尔大学妇科医院接受了盆腔镜检查。120例患者(68%)在2至3年后填写了关于治疗结果的问卷。18例患者进行周边输卵管造口术后,其中22%的病例发生了宫内妊娠,而11%的病例发生了宫外孕。37例患者进行输卵管伞端成形术后,宫内妊娠率为43%,而输卵管卵巢粘连松解术后的妊娠率为50%。4例直径为2.5至8厘米的浆膜下或肌壁间肌瘤患者,且无其他生育障碍的病理体征,在肌瘤摘除术后怀孕。2例患者足月分娩,另外2例流产。10例患者中有5例在子宫内膜异位病灶凝固或子宫内膜瘤摘除术后怀孕。在这些病例中,附件无需额外的手术治疗。盆腔镜检查发现9例存在无法治疗的输卵管内阻塞。10例患者未纳入研究,原因要么是体外受精成功,要么是异源授精后怀孕,要么是在此期间进行了子宫切除术或输卵管切除术。在放大检查显示至少有一个附件无病理改变且至少有一侧输卵管通畅的病例中,35%的患者在盆腔镜检查和输卵管通液术后的随访期内受孕。输卵管通液的治疗作用以及在生殖系统检查中未发现病理体征的心理影响仍有待推测。(摘要截选至250字)