Reconstructive surgery of the oviduct.

Tubal factors account for 50% of the causes of female sterility. Laparoscopic tubal surgery to correct infertility is absolutely contraindicated when tubal occlusion is due to genital tuberculosis, in the presence of thickened sclerotic tubes, in the presence of pelvic inflammatory disease, and in women over 37. Results of reconstructive tubal surgery for infertility have not been very successful in the past; however, improvement in technique and in the selection of patients have recently made the procedure more successful. Interventions to cure sterility include salpingolysis and ovairolysis, dilatation of fimbrial phimosis, salpingotomy, and tubouterine anastomosis for cornual occlusion of the tubes. Intrauterine pregnancy rates after such interventions vary greatly among the different authors. Tubal reanastomosis, and tubouterine implantation are becoming almost a common intervention, since the number of women seeking reversal of sterilization is definitely on the increase. In this case also, pregnancy rates vary greatly. It is very important to closely follow patients after reconstructive tubal surgery, and to keep in mind the possibility of ectopic pregnancy after any type of tubal surgery.