Tubal reanastomosis by microsurgery.

The enormous increase in the number of sterilizations performed in young women is creating a demand for reversal of this procedure. The author's experience with tubal reanastomosis using a microsurgical technique is presented. The traditional approach to cornual occlusion of the tubes has been tubouterine implantation. The demonstration that in such cases the intramural portion of the tube is often patent and that the occlusion site is located in the proximal isthmus has allowed, instead, resection and end-to-end anastomosis at the cornua. Including both tubouterine anastomosis for cornual occlusion and end-to-end anastomosis after previous sterilization, tubal reanastomosis was performed in 31 patients. The postoperative patency rate was 87%, and 64% have had intrauterine pregnancies. In the group subjected to tubal reanastomosis following a previous sterilization, 72.7% of those attempting a pregnancy and having more than 6 months' follow-up have had intrauterine gestations.