The prognostic role of salpingoscopy in laparoscopic tubal surgery

The present study was designed to evaluate the prognostic value of salpingo scopy in patients undergoing tubal laparoscopic surgery for infertility due to periadnexal adhesion or distal tubal occlusion, In addition, the clinic al value of salpingoscopy was compared with a current classification system of adnexal adhesions and distal tubal occlusion, A total of 51 patients wi th either adnexal adhesions (24 patients) or hydrosalpinx (27 patients) wer e prospectively evaluated. Salpingoscopy was performed concomitantly with s alpingo-ovariolysis or salpingoneostomy at the time of operative laparoscop y, There was no significant correlation between salpingoscopic classes and the classification system used for both the salpingo-ovariolysis and the sa lpingoneostomy groups of patients. The patients had a mean follow-up of 33 months. Patients with a normal tubal mucosa (salpingoscopic classes I and I I) had a 71% cumulative term pregnancy rate in the salpingo-ovariolysis gro up and a 64% cumulative term pregnancy rate in the salpingoneostomy group. No intrauterine pregnancies were obtained in patients with intratubal damag e (salpingoscopic classes III to V). There was a statistically significant correlation between the occurrence of a term pregnancy and the salpingoscop ic classes, but not with the classification system used. These results sugg est that patients with tubal infertility should be offered operative laparo scopy with salpingoscopy as the first step of treatment.