POSTOPERATIVE HYSTEROSALPINGOGRAPHY - RADIOGRAPHIC APPEARANCES AND CLINICAL-RESULTS FOLLOWING TUBAL SURGERY

Medical records and postoperative hysterosalpingograms on 23 women fol lowing tubal surgery who failed to become pregnant within 2-28 months were reviewed. A total of 39 tubes were analyzed. The surgical indicat ions were reversal of tubal ligation in 24 tubes and correction of tub al or perifimbrial disease in 15 tubes. Tubal ligation had been perfor med by a variety of methods. At surgery, tubal patency, as shown by ch romotubation, was seen in 37 (95%) of 39 tubes. On postoperative hyste rosalpingography, tubal spillage was present in 32 (82%) of 39 tubes. Radiographically, the tubes that spilled appeared normal except for oc casional shortening after reversal of tubal ligation. The eventual pre gnancy rate was 8 (35%) of 23 patients, with 7 intrauterine. Pregnancy occurred only in women under 35 years and was more likely in the grou p having reversal of tubal ligation. We conclude that among patients w ho do not initially become pregnant following tubal surgery for infert ility, tubal patency is restored in most. During hysterosalpingography , tubes operated on may appear normal or shortened. On long-term follo w-up, younger patients and those requiring tubal anastomosis only had a higher pregnancy rate.