An unusual complication of tubal anastomosis

Abstract

Objective To report an unusual complication associated with the use of a long-term intrafallopian stent during microsurgical tubal anastomosis. Design Case report. Setting Tertiary academic center. Patient(s) A 36-year-old woman in whom an intrafallopian stent used during a sterilization reversal procedure could not be transcervically retrieved in the office. Intervention(s) Hysteroscopic evaluation for removal of intrafallopian stent, followed by operative laparoscopy for postoperative abdominal pain. Main outcome measure(s) Patient symptoms, potential for morbidity, and review of the literature. Result(s) Hysteroscopic view of the uterine cavity failed to identify the intrafallopian stent. Laporoscopic evaluation of postoperative abdominal pain revealed significant formation of pelvic and abdominal adhesions. The 2-0 nylon suture used as an intrafallopian stent was seen sitting freely on top of the liver serosa. Adhesiolysis and successful retrieval of the stent resolved the patient’s symptoms. Conclusion(s) To our knowledge, this is the first report describing complete dislodgment and cephalad migration of an intrafallopian stent. Patient morbidity and health care costs may increase when long-term stents are used for sterilization reversal.