Case reports and long commentaries in obstetrics and gynecology
Nderitu, Charles M
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Objectives: To compare the outcomes of laparascopic and open tuboplasty among infertility patients with a tubal factor. Design: This was a retrospective cross sectional study. Setting: At Kenyatta National Hospital records department. Methods: A total of 82 files of each group were retrieved by systematic stratified sampling method. The files chosen had to meet the inclusion criteria of having tubal pathology as the sole cause of infertility and the interventional tubal surgery done between the years 1999-2003 and follow-up must have been done in KNH for a duration not less than two years to ascertain the outcome. Results: Most postoperative complications were statistically significantly different (P<O.05) in the two groups, more in patients who were done open tuboplasty. In terms of the main outcome measures 3.7% of patients done open tuboplasty achieved a normal intrauterine pregnancy compared to 6.1% of those done laparascopic tuboplasty. The difference was not statistically significant. 1.2% of the operated patients in the two groups had ectopic pregnancy as sequelae of corrective tuboplasty had miscarriage while non-in the laparascopy group. 92.7% in either group had a failure of any form of conception. Conclusions: The intrauterine pregnancy rates at K.N.H after of interventional tubal surgery are low. Laparascopic tuboplasty has a higher desired outcome than the open tuboplasty. Recommendations: There is need to classify the degree of tubal damage and decide on the best form of intervention. There is need also to change the macro surgical to microsurgical form of interventional tubal surgery procedures as it has a higher success rate for the open tuboplasty.