Comparison of Pregnancy Rate following Unilateral & Bilateral Surgical Procedures for Tubal Reversal

Keimyung Medical Journal 1990;9(2):231-240.

난관 문합술에 있어서 일측문합 및 양측문합에 따른 임신성공율의 비교

김흥열; 조치흠; 이두룡

Abstract

Between May; 1984 and November; 1989; 64 cases of tubal reversals which were performed by microsurgical techniques; in arbitary chosen; at the Department of Obstetrics & Gynecology; Keimyung University Hospital were reviewed for comparison & evaluation of pregnancy rates & its influencing factors between unilateral & bilateral tubal reversals Among them; each 32 cases were performed by unilateral reversals & bilateral reersals; respectively The mean age was 30 2 yrs in the unilateral subgroup & 31 7 yrs in the bilateral subgroup Average interval between sterilization & reversals was 48 7 months in the unilateral subgroup & 536 months m the bilateral subgroup The majority of two groups had been sterilized by laparoscopic procedures(43 8% in the unilateral subgroup & 90 7% in the bilateral subgroup) In two groups; the most common sites of the anastomosis were isthmic-ampu-lary portion in the unilateral group(37 5%) & isthmic-isthmic portion in the bilateral group(48 4%) The most common cause undergoing unilateral tubal reversals was tubal obstruction(43 8%) The postoperative length of the tube was 5cm or more in 96 9% in each subgroup Of all 64 cases; 12 cases out of 25 unilateral cases (48%) which were followed up among 32 unilateral cases and 20 cases out of 25 bilateral cases (80%) which were followed up among 32 bilateral cases; had achieved pregnancies; so then statistical difference was found in pregnancy rates between two groups (p<0 01) In pregnant women; three was no statistical signnificance in the postoperative tubal length & interval between surgery & conception favoring bilateral subgroup(p>0 05); and mean age & duration of sterilization had no statistical deference between two groups(p>0 05) Between two surgical groups; no ststistical difference was found in the pregnancy rates according to the method of previous sterilization; the sites of tubal anastomosis; the postoperative tubal length; and the duration of sten]ization(p>0 05) The rates of spontaneous abortion were 17% (2 cases/12 cases) in the unilateral subgroups and 10% (2ases/20 cases) in the bilateral subgroups; and the rate of ectopic pregnancy was 17% (2 cases/12 cases) in the unilateral subgroup & 10% (2 cases/20 cases) in the bilateral subgroup; again showing no ststistical difference in the rates of spontaneous abortion & ectopic pregnancy(p>0 05)

Key Words: Microsurgery Pregnancy rate Unilateral and bilateral tubal anastomosis