Reversal of female sterilization: comparison of microsurgical and gross surgical techniques for tubal XXXX .

@entity1 @entity254 @entity3521
Between 1977 and 1979, 34 consecutive, unselected @entity1 had a reversal of tubal sterilization. The characteristics of 23 @entity1 with more than a 6-month follow-up after end-to-end @entity254 are given, as are details of the operative procedures used. The overall intrauterine pregnancy rate was 56%, and the most reversible sterilization procedures, in terms of intrauterine pregnancies, were the Pomeroy, Uchida, and @entity3521 (67%). The least reversible were unipolar tubal cautery (42%) and fimbriectomy (50%). Eleven @entity1 had a microsurgical procedure (with the microscope) and 12 a gross surgical procedure. The use of the microscope was not associated with a significantly better pregnancy rate in cases matched for poststerilization tubal length, proximal and distal to the uterus. But insufficient numbers of tubal cautery reversals have been performed for an evaluation of the use of the microscope in this particular situation. The site of the @entity254 and the postoperative length of the tube were good predictors of intrauterine pregnancies. Five of six @entity1 who had isthmus-isthmus anastomoses on at least one side had term vaginal deliveries. Likewise, 10 of 16 @entity1 in whom the length of the longest tube was 6 cm or more had viable pregnancies, but only one of seven @entity1 had a viable pregnancy with tubes of 5 cm or less.
