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Postoperative hysterosalpingography. Radiographic appearances and clinical results following tubal surgery.

Medical records and postoperative hysterosalpingograms on 23 women following tubal surgery who failed to become pregnant within 2-28 months were reviewed. A total of 39 tubes were analyzed. The surgical indications were reversal of tubal ligation in 24 tubes and correction of tubal or perifimbrial disease in 15 tubes. Tubal ligation had been performed by a variety of methods. At surgery, tubal patency, as shown by chromotubation, was seen in 37 (95%) of 39 tubes. On postoperative hysterosalpingography, tubal spillage was present in 32 (82%) of 39 tubes. Radiographically, the tubes that spilled appeared normal except for occasional shortening after reversal of tubal ligation. The eventual pregnancy rate was 8 (35%) of 23 patients, with 7 intrauterine. Pregnancy occurred only in women under 35 years and was more likely in the group having reversal of tubal ligation. We conclude that among patients who do not initially become pregnant following tubal surgery for infertility, tubal patency is restored in most. During hysterosalpingography, tubes operated on may appear normal or shortened. On long-term follow-up, younger patients and those requiring tubal anastomosis only had a higher pregnancy rate.