SEARCH · Search PubMed

Results for “Fimbriectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed2006

[Male and female sterilization techniques: Summary of ANAES assessments (May 2005)].

OBJECTIVE: To summarize assessments carried out by ANAES on male and female sterilization techniques. The summary was requested by the French Health Directorate after the law authorizing sterilization as a means of contraception was passed. RESULTS (FEMALE STERILIZATION): (i) EFFICACY of tubal ligation, electrocoagulation, clips or rings: the annual pregnancy rate is 0-2% depending on the study, with no significant difference between techniques. No data were found on fimbriectomy. (ii) EFFICACY of a hysteroscopically placed micro-insert device: no pregnancies were observed in patients with bilateral tube obstruction diagnosed by hysterosalpingography at 3 or at 6 months after placement (placement rate: 87-89%). (iii) SAFETY of tubal ligation, electrocoagulation, clips or rings: (a) By approach: There was no difference in the incidence of major complications between laparoscopy and minilaparotomy but there were significantly fewer minor complications with laparoscopy than with minilaparotomy. There were significantly more major complications with culdoscopy than with minilaparotomy and significantly more minor complications than with laparoscopy. (b) By operative technique: major and minor complications were significantly more common with the Pomeroy technique than with electrocoagulation; the difference could be due to the approach used. No data were available on fimbriectomy. (iv) SAFETY of a hysteroscopically placed micro-insert device: there were 11 cases of myometrial or tubal perforation among 734 patients (with device displacement into the peritoneal cavity in 3 cases). RESULTS (MALE STERILIZATION): (i) EFFICACY: efficacy varied from 84% to 100% depending on the approach and the mode of vas deferens obstruction. There was no significant difference in efficacy according to approach (transcutaneous or scrotal). However, no conclusion could be drawn on the comparative efficacy of the occlusion techniques used from published data. (ii) SAFETY: the rate of postoperative complications was low, below 10% in most series. Complications were benign and only rarely necessitated surgical revision. CONCLUSION: The advantage of sterilization methods is that they lack any permanent contraindication. They should be presented as being generally irreversible. Fimbriectomy is not recommended for female sterilization. Laparoscopy is the preferred approach. Sterilization by hysteroscopic placement of a micro-insert device should be restricted to cases presenting a risk on laparoscopy; the technique should be re-assessed in 2006. The two approaches used for male sterilization are technically similar and do not seem to differ in efficacy. The Public Health Code states that "Fallopian tube or deferens duct ligation for contraceptive purposes is not allowed in minors" and that ligation "cannot be performed unless the adult involved has given his/her informed and motivated consent, expressed after taking into consideration clear, complete information on the consequences of the procedure". A waiting period of four months must follow the moment the decision to sterilize is taken and consent is given. An informed consent form must be signed. Sterilization in young or nulliparous women should be proposed with the greatest prudence and with many reservations.

Adolescent↗

PubMedDate not supplied

Tubal sterilization and ovarian perfusion: selective arteriography in vivo and in vitro.

To determine whether there are changes in the utero-tubo-ovarian circulation after tubal sterilization, selective arteriograms were taken in vivo every 0.3--7.0 seconds with a Puck-type seriograph and also in vitro. A control arteriographic study was made. The operations performed were fimbriectomy and modified Pomeroy. The 30 patients studied were divided into two groups. One was formed by 20 nonpregnant women. The other ten patients were in the early puerperium. Arteriographic images with and without tubal sterilization were prepared, and the different techniques were compared. With the Pomeroy operations, the various tubal sites where surgery was performed were also compared. It was concluded that neither the modified Pomeroy sterilization nor fimbriectomy alters ovarian perfusion in either nonpregnant women or those in the early puerperium.

Adnexa Uteri↗

PubMed1994

Effects of chronic nerve growth factor treatment on hippocampal [3H]cytisine/nicotinic binding sites and presynaptic nicotinic receptor function following fimbrial transections.

Recent studies with nerve growth factor (NGF) have identified the pharmacological actions of this neurotrophin in a variety of animal models that mimic some of the neurotransmitter deficits that occur in Alzheimer's disease (AD, for reviews see Refs 7, 15, 17, 19). Based upon extensive pharmacological studies, NGF has been characterized as a crucial maintenance factor for adult cholinergic neurons of the septo-hippocampal and basalo-cortical pathways. Among the reported actions of NGF is an attenuation of lesion-induced decrements in presynaptic and postsynaptic cholinergic markers and functions in the hippocampal formation. Thus, in studies that used partial fimbriectomies to parallel the cholinergic neurodegeneration that occurs in AD, intraventricularly administered nerve growth factor prevented the loss of choline acetyltransferase (ChAT) and acetylcholinesterase immunoreactivity in the septum and increased a variety of presynaptic cholinergic markers involved in the synthesis, storage and release of the neurotransmitter acetylcholine (for reviews see Refs 7, 17, 19). More specifically, chronic NGF treatment attenuates lesion-induced reductions in hippocampal ChAT activity and high-affinity choline uptake, the end-result of which is an enhanced capacity to synthesize acetylcholine. This increased acetylcholine synthesis, in turn, appears to translate directly into augmented vesicular storage and release of the neurotransmitter. For instance, not only does NGF treatment reverse lesion-induced reductions in maximal binding densities of the acetylcholine vesicular transport marker [3H]vesamicol, but it also enhances acetylcholine release and turnover rate. NGF treatment also appears to restore the sensitivity of postsynaptic muscarinic receptors to agonist-induced stimulation following partial fimbriectomies.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaloids↗

PubMed1994

Concurrent tuboplasty and assisted reproduction.

OBJECTIVE: To review and summarize the role of combining assisted reproductive technologies (ART) with lysis of adhesions and microsurgical tuboplasty in selected groups of patients. DESIGN: A retrospective analysis of the available literature and a review of the results of concurrent fimbriectomy reversal and ART. CONCLUSION: In a relatively few and highly selected patients, the concurrent use of ART and laparotomy or laparoscopy for lysis of adhesions and tuboplasty can more safely access the ovaries for oocyte retrieval and address associated problems such as pelvic pain while reducing cost. Examples of such cases include patients with ovaries in abnormal locations, on a congenital basis or after extensive bowel or urogenital reconstructive surgery. Because some procedures such as fimbriectomy reversal have a relatively low fecundity, there is potential for increasing cumulative pregnancy rates when ART and microsurgery are combined. The advantages of increased fecundity and cost-effectiveness must be weighed against the disadvantages of operating room scheduling and the potential surgical and anesthetic risks.

Fallopian Tube Diseases↗

PubMed1984

Indications for the treatment of tubal infertility patients by microsurgery or in vitro fertilization.

Pregnancy rates following the treatment of tubal infertility patients by microsurgery or in vitro fertilization (IVF) have been analysed. The results indicate that microsurgery should be the primary treatment for the following: (a) Sterilization reversal (except fimbriectomies or tubes of less than 3cm length); (b) Incomplete lateral tubal occlusion; (c) Medial tubal occlusion; (d) Peritubal or periovarian adhesions. IVF is indicated as the primary treatment for tubal infertility patients when investigation demonstrates (a) Total lateral tubal occlusion; (b) Previous fimbriectomy sterilizations; (c) Reconstructable tubal length of less than 3cm.

Female↗

PubMed1989

[Sterilization failures following fibrectomy].

Four of 272 patients with bilateral fimbriectomy became pregnant. In each of the four cases the distal end of the Fallopian tubes was closed but a tubo-peritoneal fistula could be observed in the antimesenterial part of the tube - immediately proximal of the former ligatures. These failures of sterilization were all found in a group of 16 patients, in which VICRYL 2/0 was used for ligation after resection of the fimbriated end. In all the other cases of fimbriectomy Chromcatgut 2/0 was used.

Adult↗

PubMedDate not supplied

Changes in menstrual blood loss and libido after different methods of tubal ligation.

A study was carried out to investigate the menstrual blood loss and changes in sexual life following two methods of tubal sterilization, the Pomeroy procedure and fimbriectomy, as compared with a control group having undergone Cesarean section alone. Results support the approach that hysterectomy be performed in older women, over the age of 40, and fimbriectomy in younger patients, in whom further pregnancy or reanastomosis of the Fallopian tube is absolutely contraindicated.

Adult↗

PubMed1986

Microsurgical reversal of sterilization: a six-year study.

A prospective study of 113 personal consecutive microsurgical reversals of female sterilization during the 6-year period from 1979 to 1984 was carried out to determine factors affecting the pregnancy rate. The sterilizations were performed by laparoscopic unipolar coagulation in 54% of the patients, by the Pomeroy technique in 28%, by fimbriectomy in 8%, by the Irving operation in 5%, and by clips or rings in 4%. In the group with no minimum follow-up period, 50% had intrauterine pregnancies and 5% had ectopic gestations. Eighty-nine patients had at least 12 months of follow-up after reversal surgery. This group is studied in detail. Factors affecting the pregnancy rate were length of tube, type of sterilization performed, anastomotic site, and availability of both tubes for reconstruction. Age, parity, and interval from sterilization to reversal surgery did not affect the pregnancy rate. Fifty percent of the intrauterine pregnancies were conceived within 6 months of reversal surgery.

Abortion, Spontaneous↗

PubMed1985

Sterilization failures and their causes.

To say that a sterilization failure rate is expected does not answer why. Forty-seven cases of repeat sterilization have undergone such surgical and pathologic scrutiny. Resection methods failed most frequently because of spontaneous reanastomosis or fistula formation. Fimbriectomy was particularly vulnerable to reanastomosis because the fimbria ovarica was not removed. Mechanical devices failed when the device was defective, placed improperly, or placed in an improper location. Tissue damage was evident but incomplete when the bipolar electrocoagulation method failures were reviewed, and the endosalpinx remained viable. Unipolar method injuries, in contrast, were complete; they failed by fistula formation. Thus bipolar method failures may occur because of the limited range of electrical power available when using bipolar generators. Some sterilization failures are preventable, but many are not. When medicolegal questions arise, these findings may help answer the question, Why?

Contraceptive Devices, Female↗

PubMed1976

Minilaparotomy for female sterilization: a feasibility study of a new technique.

Female sterilization via a minilaparotomy incision was performed on 30 patients at Al-Azhar University Teaching Hospital in Cairo, Egypt. A uterine sound fed through a Foley catheter was used as a uterine elevator. A 2 cm suprapubic transverse laparotomy was performed and sterilization was accomplished by fimbriectomy. Twenty patients received general anesthesia and 10 patients initially received local anesthesia. Surgical time ranged from 7 to 15 min, and the average duration of hospitalization was 8 hours. Blood loss was small, and no patient was transfused. One patient had a wound infection. This pilot study indicates that this procedure is relatively simple, safe and inexpensive.

Female↗

PubMed1978

Experience with minilaparotomy in the Philippines.

This paper presents the socio-demographic characteristics, medical histories, and clinical data on 651 women sterilized by interval minilaparotomy procedures in Manila, Philippines. About two thirds of the procedures were performed with local anesthesia; the Pomeroy technique was used for tubal ligation. In 2.8% of the patients, salpingectomy or fimbriectomy was performed on one side because of surgical difficulties and complications. Surgical difficulties were encountered in 19.8% of the procedures; adhesions (4.3%) and bowel interference (4.0%) were the most frequent causes of surgical difficulty. Complications occurred during surgery in 1.7% of the procedures. Early postoperative complications were noted in 9.1% of the cases. None of the patients required readmission to the hospital. While 612 women were followed up at 6 months, 299 were followed up at 12 months. One women (0.2%) became pregnant after sterilization; at repeat minilaparotomy, ligation of the left round ligament rather than the tube was observed. Pelvic surgery, other than pregnancy-related surgery, during the year following sterilization was reported for one patient who underwent exploratory laparotomy with appendectomy and oophorocystectomy. Menstrual pattern changes were minimal. The results of this study suggest that tubal ligation via minilaparotomy is practical, safe, and effective.

Adult↗

PubMedDate not supplied

Risks and benefits of culdoscopic female sterilization.

This paper reviews the risks and benefits of the culdoscopic approach to female sterilization in an alnalysis of 2153 culdoscopic sterilization procedures performed at 11 centers in nine countries. Inability to occlude the tubes as planned was reported for approximately 6.0% of the cases including 1.4% in which one or both tubes could not be occluded by any technique. Surgical difficulties were reported for about 13.0% of the procedures, and surgical complications, of which the most frequent was torn or bleeding tubes, occurred in 2.0% of the cases. Pregnancy rates were significantly higher for patients whose tubes were occluded by tantalum clips (7.7 per 100 women at 12 months), indicating that this is not the preferred technique of tubal occlusion; the 12-month life table pregnancy rates were 0.1 per 100 women for tubal ring and 0.0 for Pomeroy and fimbriectomy. Comparison of these data with similar pooled data on laparoscopy and minilaparotomy indicates that culdoscopy is associated with greater technical difficulty and morbidity. Thus, abdominal procedures will continue to be preferred for use in most large-scale programs.

Culdoscopy↗

PubMed1987

Nerve growth factor protein level increases in the adult rat hippocampus after a specific cholinergic lesion.

Nerve growth factor (NGF) is the best-characterized neurotrophic substance and has recently been shown to influence cholinergic neurons in the basal forebrain. Hippocampus and neocortex, the primary targets for these central neurons, have further been found to contain high levels of NGF. Using enzyme immunoassay and acetylcholine esterase (AChE) histochemistry we have now studied the levels of NGF and AChE after a specific cholinergic lesion, transection of the fimbria fornix comprising the major cholinergic input to hippocampus. Fimbriectomy in adult rats led to a marked decrease in AChE-positive nerve terminals in both hippocampus and neocortex 10 days later, and to an increase (40%) of NGF protein concentration in hippocampus. thirty days after surgery, NGF had returned to control levels and remained there after 90 days. Removal of superior cervical ganglion did not alter the results. The density of cholinergic terminals in both hippocampus and neocortex increased with time (90 days) after fimbrial transection. The results support the idea that cholinergic neurons in the basal forebrain take up and retrogradely transport NGF from their target areas and suggest that transection of the pathway interrupts the transport thereby increasing NGF distal to the lesion. The return of NGF to control levels probably reflects reestablished cholinergic contracts in the hippocampus.

Animals↗

PubMed1995

Menstrual disorders and pelvic pain after sterilization.

Changes in menstrual cycle length, menstrual duration, number of pads, dysmenorrhea and non-cyclic pelvic pain were studied in 43 women following tubal sterilization with three different techniques. One group consisted of 17 women undergoing laparotomy by Pomeroy technique; the second group consisted of 11 women undergoing laparoscopy by Fallope rings; and the third group consisted of 15 women undergoing colpotomy by fimbriectomy. The differences before and after sterilization in cycle length were non-significant in all groups (p > 0.05). After sterilization, menstrual duration and number of pads were significantly increased in the laparotomy (p < 0.001) and laparoscopy (p < 0.01) groups but non-significantly in the colpotomy group (p > 0.05). Comparison of these parameters between the groups did not show any significant differences (p > 0.05). After sterilization, increases in the severity of dysmenorrhea and non-cyclic pelvic pain were non-significant in all groups (p > 0.05). We concluded that there were no significant differences in menstrual disorders after sterilization among these three different techniques.

Adult↗

PubMed1975

Uchida tubal sterilization.

The methods which seek to close the tubes by tissue necrosis may be responsible for subsequent pathologic disorders. These sequelae often explain postoperative repeat uterine pregnancy, ectopic gestation, and other serious complications. In addition to Uchida sterilization, the Uchida fimbriectomy is recommended for use in the immediate postpartum period and at cesarean section because of its many advantages.

Adnexal Diseases↗

PubMed1977

Hysterosalpingographic follow-up of the partial salpingectomy type of sterilization.

Two hundred and eleven of 743 patients with salpingectomy-type sterilization had hysterosalpingographic (HSG) follow-up. This type of sterilization was performed post partum, electively suprapubic, vaginally (including fimbriectomies), or at the time of cesarean section. A Foley catheter technique was used for hysterosalpingography. Of these, 1.895 per cent had fistula on hysterosalpingography. Mechanism of fistula formations and recanalization is discussed. A modification of the Pomeroy sterilization procedure is described and discussed.

Fallopian Tubes↗

PubMed1981

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

Between 1977 and 1979, 34 consecutive, unselected patients had a reversal of tubal sterilization. The characteristics of 23 patients with more than a 6-month follow-up after end-to-end anastomosis 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 Falope ring (67%). The least reversible were unipolar tubal cautery (42%) and fimbriectomy (50%). Eleven patients 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 anastomosis and the postoperative length of the tube were good predictors of intrauterine pregnancies. Five of six patients who had isthmus-isthmus anastomoses on at least one side had term vaginal deliveries. Likewise, 10 of 16 patients in whom the length of the longest tube was 6 cm or more had viable pregnancies, but only one of seven patients had a viable pregnancy with tubes of 5 cm or less.

Adult↗

PubMed1984

The reversibility of female sterilization with the use of microsurgery: a report on 102 patients with more than one year of follow-up.

A prospective study of 102 patients who underwent a reversal of sterilization between January, 1977, and February, 1982 revealed a pregnancy rate of 68% after more than 1 year of follow-up. The term delivery, abortion, and ectopic pregnancy rates were 52%, 11%, and 5%, respectively. The most reversible procedure was placement of the Falope ring (83% term delivery), and the least reversible was fimbriectomy (29%). The use of the microscope in performing tubal operation was associated with term delivery rates (60%) higher than those when no microscope was used (44%); this was particularly significant after tubal cautery (50% versus 25%). A total remaining tube length of 6 cm or more after previous sterilization resulted in a much better (74%) term delivery rate after microsurgical procedures than that in patients with shorter tubes (44%). The most successful site for tubal anastomosis was isthmus-isthmus and cornu-isthmus, with 81% and 67% term delivery rates, respectively.

Abortion, Spontaneous↗