Abstract
BackgroundSalpingotomy may change the anatomical structure and patency of the fallopian tube, which may affect the fallopian function. This study is to investigate the clinical efficacy of preliminary hysteroscopic tubal hydrotubation (HTH) after laparoscopic salpingotomy for tubal ampullary pregnancy.MethodsA retrospective study was carried out, 140 women underwent laparoscopic salpingotomy for ampullary pregnancy from March 2013 to March 2017. Some patients received HTH in the 1st month and hysterosalpingography (HSG) in the 3rd month after salpingotomy (HTH group; n = 95), and some patients only received HSG in the 3rd month after salpingotomy (control group; n = 45). Clinical data, tubal patency and fertility outcome were evaluated after follow-up of 15 months.ResultsThe tubal patency rate of the operated side was significantly higher in the HTH group than that in the control group (89.47% vs 68.89%, P < 0.05). The intrauterine pregnancy (IUP) rate was significantly higher in the HTH group (76.47% vs 51.11%, P < 0.05), and the recurrent ectopic pregnancy rate in the operated side was significantly lower in the HTH group than in the control group (9.41% vs 22.22%, P < 0.05). Logistic regression analysis showed that the positive factor for IUP was HTH (OR = 3.109, 95% CI 1.439–6.714, P = 0.004), while the negative factors were history of pelvic inflammatory disease (PID) (OR = 0.167, 95% CI 0.074–0.377, P < 0.001) and history of tubal infertility (OR = 0.286, 95% CI 0.113–0.723, P < 0.05).ConclusionPreliminary HTH after laparoscopic salpingotomy for ampullary pregnancy could improve reproductive function and lead to a better fertility outcome. Patients without history of PID or tubal infertility may be the most suitable ones for HTH after salpingotomy.
Highlights
Salpingotomy may change the anatomical structure and patency of the fallopian tube, which may affect the fallopian function
Based on whether patients received hysteroscopic tubal hydrotubation (HTH) in the 1st month after the operation, the patients were assigned into two groups: the HTH group (n = 95) underwent HTH in the 1st month and HSG in the 3rd month after the operation, and the control group (n = 45) received only HSG in the 3rd month after salpingotomy
There were no significant differences in gravidity, parity, history of pelvic inflammatory disease (PID) or history of tubal infertility between the two groups (P > 0.05)
Summary
Salpingotomy may change the anatomical structure and patency of the fallopian tube, which may affect the fallopian function. This study is to investigate the clinical efficacy of preliminary hysteroscopic tubal hydrotubation (HTH) after laparoscopic salpingotomy for tubal ampullary pregnancy. Ectopic pregnancy (EP) occurs approximately 1–2% of all pregnancies [1]. 98% of ectopic pregnancies occur in the fallopian tube, and the ampullary portion is the most common site of implantation [2]. EP is a fertility-related problem for the reproductive-aged women desiring a future pregnancy [3]. Laparoscopic surgery is the preferred treatment [4]. Wu et al BMC Surgery (2022) 22:53 are two types of surgical procedures for tubal pregnancy: the radical approach (salpingectomy) and the conservative approach (typically salpingotomy). Salpingectomy has been the standard procedure to remove ectopic pregnancy until laparoscopic salpingotomy was first introduced in 1993 by Bruhat et al [5]
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