Female Reproductive Surgery
Female reproductive surgery repairs fertility problems that cannot be treated with medication. It enables accurate diagnosis of infertility issues and may also eliminate the need for more advanced treatments, including in vitro fertilization (IVF) and other assisted reproductive technology (ART) procedures. Many causes of infertility, including fibroids, cysts, polyps, adhesions, endometriosis, tubal blockage, hydrosalpinx and certain birth defects can be treated surgically through one or another of the following procedures.
Tubal ligation, in which the fallopian tubes are tied, cauterized, or sealed with a clip or ring, is considered a permanent method of birth control. Sometimes, however, a woman changes her mind and requests tubal reanastomosis (tubal-ligation reversal). Tubal reanastomosis is performed to reattach the ends of the fallopian tubes through a small incision. Women who have had only small portions of their tubes removed, or whose tubes were sealed using clips or rings, are the best candidates for tubal reanastomosis.
Hysteroscopy enables the physician to view, and often correct, problems in the uterus. During hysteroscopy, the cervix is gently dilated, and then expanded with either gas or fluid. A hysteroscope, a thin, flexible tube with a camera and light, is inserted through the vagina and into the uterus. Hysteroscopy is also used to repair or remove polyps, uterine fibroids and intrauterine adhesions.
Tubal cannulation is performed to correct cornual occlusion, which is a blockage in a fallopian tube. Using fluoroscopy or hysteroscopy, a thin wire is inserted through the cervix and uterus to open the tube and clear the blockage.
Neosalpingostomy is a laparoscopic procedure that treats hydrosalpinx, a condition in which a fallopian tube is blocked and filled with fluid. Neosalpingostomy folds back the blocked end of the tube. The success of neosalpingostomy depends on the amount of tubal damage and number of adnexal masses (cysts).
Considerations of Reproductive Surgery
When conditions are able to be corrected during a laparoscopic diagnostic procedure, they may heal faster and be less costly than those that require conventional surgery. Treatment options should be discussed with the physician before deciding on a particular procedure.