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We exclusively specialize in tubal reversal surgery and the surgical repair of blocked fallopian tubes.

Most of our patients travel to our center for reversal of tubal ligation, but we also have patients who come for tubal surgery to repair fallopian tubes blocked from scar tissue.

Often this scar tissue has formed because of a previous pelvic infection, surgery, or an ectopic pregnancy. This scar tissue can often form either at the beginning or at the end of the fallopian tube.

Tubal blockage caused by scar tissue can often be repaired with microsurgical tubal surgery. This can allow many women an alternative to in-vitro fertilization and the chance to become pregnant naturally.

Tubal Blockage At The End

The most common type of tubal blockage is when scar tissue forms at the very end of the fallopian tubes. This causes the tubal fimbria (the area of the tube where they egg is received from the ovary) to close. This type of tubal scar tissue will prevent pregnancy from occurring.

ampullary salpingostomy for hydrosalpinx repairThe most common cause for blockage at the end of the tube is from a previous pelvic infection, but any insult to the tube (ectopic pregnancy, endometriosis, surgery) can cause this type of tubal blockage.

When the tubal blockage is severe the fallopian tube will swell with fluid and the swollen tube is often called a tubal hydrosalpinx.

A hydrosalpinx can be repaired with a microsurgical salpingostomy procedure. During this procedure the scar tissue is removed and the end of the tube is reopened. This surgical repair will allow pregnancy to occur.

Fallopian Tube Blockage At The End

fimbriectomy can be repaired with ampullary salpingostomy procedureSome women will undergo an uncommon type of tubal ligation where the fimbrial ends of the tubes are tied, cut, and the fimbrial tissue is removed.

This type of tubal ligation procedure is uncommon and is called a fimbriectomy tubal ligation.

Fimbriectomy can be repaired with a microsurgical salpingostomy and allow women the ability to become naturally pregnant.

Microsurgical Salpingostomy

When the tubes are blocked either from a hydrosalpinx or fimbriectomy this can be repaired with a microsurgical salpingostomy procedure.

The chance of pregnancy after microsurgical salpingostomy depends on the age of the patient and the health and length of the remaining tube.

The pregnancy rate at one year following microsurgical salpingostomy is approximately 30 to 40%.

Tubal Blockage At The Beginning Of The Tube

It is less common to have blockage at the beginning of the fallopian tube. The most common reason to have blockage at the beginning of the fallopian tube is from an Essure sterilization procedure. The next most common reason to have blockage at the beginning of the tube is from Salpingitis Isthmica Nodosa (SIN).

tubouterine-implantation-for-repair-of-proximal-blockageSalpingitis Isthmica Nodosa is a condition which is not very well understood but often occurs in the beginning of the fallopian tube as it travels through the muscle of the uterus.

This condition causes progressive tubal scarring that can cause patients to have multiple ectopic (tubal) pregnancies. Ultimately this condition can progress to complete tubal blockage.

This condition can often be reversed through a tubouterine implantation procedure. We commonly perform tubouterine implantations for reversal of Essure sterilization, but this type of tubal repair can also correct blockage in the beginning part of the tube from other causes.

The pregnancy rate one year following tubouterine implantation ranges from 25 to 50%.

258 thoughts on “Tubal Repair”

  1. Anonymous says:

    I am 38 years old I have had two tubal pregnancies. 1 tube (I believe) was removed and the other was clipped. So my question is would I be able to get reconstructive surgery on my tubes? I want nothing more than to have at least one child so could you get back with me and let me know how to go about starting everything I need to know if I am able to have a child naturally

    1. Dr. Monteith says:

      If your tube was clipped because you were having IVF treatment had a hydrosalpinx (tube filled with inflammatory fluid), then I would not recommend tubal reversal. If your tube was clipped during a routine tubal ligation to prevent pregnancy then you would be a good candidate for tubal reversal.

      We would need to see the surgical records from when the tube was clipped. Please call us at (919)977-5050 if you have any questions.

  2. Mel says:

    Hello, i had tubal reversal at nccrm Nov 2016 with 10 left both tubes, i had fibroids removec Aug 2016 small fibroids. In march 2017 had hsg test and was told scar tissue was not allowing dye to flow into either of my tubes. Is there anything that can be done outside of ivf. Also im 41.

    1. Dr. Monteith says:

      Your options are either a second tubal reversal procedure or IVF. We will often repeat tubal reversal when others have not had success with other reversal doctors but we do not offer IVF. If you would like to consider a second attempt at tubal reversal then you can send us your tubal reversal surgery operative note and the HSG report. We can then see if you are a candidate for a second surgery. Please call us at (919)977-5050 if you have any questions.

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