Tubal Surgery

Question 1

type of HSG contrast associated with higher fecundity rates

Answer 1

oil based

Question 2

percent of patients in whom HSG showed proximal tubal blockage with tubal patency 1 month later

Answer 2

60%

Question 3

considerations for tubal corrective surgery vs IVF

Answer 3

female age, ovarian reserve, number of kids desired, location/extent of blockage, sperm quality, risk of ectopic, experience of the surgeon

Question 4

reason why tubal surgery and IVF results are difficult to compare

Answer 4

tubal surgery reports pregnancy per patient whereas IVF is pregnancy per cycle

Question 5

etiologies for proximal blockage

Answer 5

plugs of mucus or debris, spasms or a true occlusion

Question 6

etiologies for true blockages of the proximal tube

Answer 6

endometriosis, salpingitis isthmica nodosum, PID

Question 7

reocclusion rate for tubal cannulation

Answer 7

33%

Question 8

good prognosis distal occlusion defined as

Answer 8

filmy adhesions, mildly dilated tubes <3cm, thin and pliable walls, lush endosalpinx with preservation of mucosal folds

Question 9

reversal of sterilization procedures best with

Answer 9

rings or clips than ligation/resection or cautery

Question 10

good prognosis for tubal sterilization reversal

Answer 10

age <37, rings or clips, >4cm tube length

Question 11

rate of ectopic after tubal reversal

Answer 11

4-8% (IVF is 1.4%)