Results of modern tuboperitoneal infertility treatment

Abstract

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.Uvod/Cilj. Savremeni pristup operativnog lecenja tuboperitonealnog infertiliteta bazira se na primeni laporaskopskih tehnika. Cilj ovog rada bio je poredjenje rezultata operativnog lecenja tuboperitonealnog infertiliteta primenom laparoskopije i klasicne laparotomije. Metode. Uradjena je retrospektivno-prospektivna studija na 66 zena operativno lecenih od infertiliteta tuboperitonealnog porekla. Za retrospektivnu analizu korisceni su podaci iz istorija bolesti operisanih zena (prethodno dijagnostikovanje uzroka infertiliteta, spermogram, histerosalpingogram, laparoskopija, utvrdjivanje ovulacije, hormonsko ispitivanje), dok je prospektivna studija kojom su dobijeni podaci o rezultatima operativnog lecenja peritonealnog infertiliteta (laparoskopijom i klasicnom laparotomijom) uradjena metodom ankete. U statistickoj analizi primenjen je neparametarski ?2 test. Za nivo statisticke znacajnosti uzeto je p < 0,05. Rezultati. U periodu od 1996. do 1997. godine, 34 zene operisane su klasicnom laparotomijom (grupa I), a u periodu od 1999. do 2000. godine 32 zene operisane su laparoskopski (grupa II). Dobijeni su sledeci rezultati: ukupan broj nastalih trudnoca bio je 16 (24%), a od toga sedam u grupi I (20,6%) i devet u grupi II (28,1%). Bilo je 13 bolesnica sa po jednom trudnocom, tj. sest u grupi I (17,6%) i sedam u grupi II (22%). Po dve trudnoce imale su tri zene u grupi I (2,9%) i dve u grupi II (6,2%). Sto se tice ishoda trudnoce, pet bolesnica imalo je spontani pobacaj, dve u grupi I (5,9%) i tri u grupi II (9,4%); dve bolesnice imale su vanmatericnu trudnocu, obe u grupi I (5,9%); tri prevremeni porodjaj, jedna u grupi I (2,9%), i dve u grupi II (6,2%); terminski porodjaj imalo je sest bolesnica dve u grupi I (5,9%), i cetiri u grupi II (12,5%). Statistickom obradom podataka nadjeno je da izmedju ove dve grupe nema statisticki znacajne razlike u broju nastalih trudnoca. Zakljucak. Hirursko lecenje tuboperitonealnog infertiliteta, bez obzira na to da li je izvedeno klasicnom operacijom ili laparoskopski, dovelo je do velikog broja trudnoca. Prednosti ovih metoda u odnosu na in vitro fertilizaciju, kao poslednju mogucnost u lecenju tuboperitonealnog infertiliteta, velike su i ne smeju biti zanemarene.