Pregnancy after bilateral fimbrioplasty: classic corrective operation on fallopian tubes in the era of laparoscopy progress and assisted reproductive techniques - case report

Tubarni čimbenik kao uzrok bračnog steriliteta u praksi susreće se u oko 30 do 40% slučajeva. Zbog sve boljih rezultata metoda asistirane reprodukcije, mikrokiruški zahvati na jajovodima moraju biti jasno indicirani, bez obzira na to rade li se takvi zahvati laparotomijskim ili laparoskopskim pristupom. Prikazali smo slučaj fimbrioplastike u 35-godišnje žene liječene zbog sekundarnog bračnog steriliteta prije 12 godina. Također smo opisali trudnoću i porod ove žene. Uzrok steriliteta je bila obostrana terminalna okluzija jajovoda, dokazana rendgenskom histerosalpingografijom. Obrada pacijentice započeta je nakon tri godine sekundarnog steriliteta. Uredna intrauterina trudnoća ostvarena je u prvom pokušaju, dva mjeseca nakon obostrane fimbrioplastike. Trudnoća i porod navedene pacijentice protekli su uredno. Cilj ovoga rada je da se s vremenskim odmakom od 12 godina prikažu prijašnji tehnički operativni dosezi u ovom području ginekološke kirurgije, te da se iz današnje perspektive analiziraju rezultati klasičnih korektivnih operacijskih zahvata u području jajovoda s onima koji se danas izvode laparoskopskom operativnom tehnikom.Tubal infertility factor as a cause of matrimonial sterility is encountered in practice in about 30 to 40% of cases. Since the results of assisted reproduction techniques are improving every day, microsurgical procedures on Fallopian tubes must be strictly indicated, even if such procedure is done by laparotomic surgery or laparoscopic approach. In this article, we present a case of fimbrioplasty in a 35-year-old woman, who was treated for secondary infertility 12 years ago. Also, we describe the pregnancy and delivery of this woman. The cause of infertility was bilateral distal tubal occlusion, confirmed by x-ray hysterosalpingography. This patient started treatment within three years of secondary infertility diagnosis. Regular intrauterine pregnancy was achieved by first attempt, two months after bilateral fimbrioplasty. The course of pregnancy and delivery were normal. The aim of this article is to assess technical achievements of gynecological surgery, during a 12-year time span, and also to analyze the results from today\u27s perspective of classical corrective surgical procedures on the Fallopian tubes, compared to those that are now performed by laparoscopic operative techniques