Tubal Reversal Surgery (Tuboplasty)
A tuboplasty is a surgical repair of the fallopian tubes, which carry the fertilized egg from the ovary to the uterus. Often these tubes become damaged intentionally for the purpose of sterilization or unintentionally by previous infection, surgery, or scar tissue produced by endometriosis. The repair of the fallopian tubes is a very highly specialized gynecological surgery and requires the physician to have additional training and experience. For the most successful outcome, microsurgical training and an operating microscope are necessary. Laser therapy is available also, but in spite of the tremendous amount of publicity that laser therapy has generated, there is currently no scientific evidence that it is superior to meticulous microsurgical technique.Candidates for Surgery
Any woman who is infertile because of blocked tubes may benefit from this surgery. Each case should be carefully assessed individually. Dr. Assad will want to review records of any previous gynecological surgery as well as fertility test that you have had done. The operative and pathology report from the tubal sterilization, if you have had one, is particularly important. Prior to surgery, it is important to know the status of the other components of reproduction such as a semen quality.Success of Surgery
The fallopian tube is a very complex structure. It not only functions as a conduit for the egg and the sperm to meet, but also provides nourishment for these germ cells during their journey. The inside of the tube is very small, a little less then the diameter of a ballpoint pen cartridge in some areas. Often, a damaged portion of the tube can be removed and the healthy ends sewn back together. Sometimes if there is not enough tube, the remaining portion of the tube can be reimplanted into the backside of the uterus. If the end of the tube is closed, it can be reopened and tied back in place. Each of these types of tuboplasty or repair has a different success rate. The range of success may vary from 50-70%. These figures have been achieved by Dr.Assad over a ten-year period and are comparable to results seen in the United States in larger fertility centers.The factors that seem to be associated with the most success are having a remaining tube of about 6 cm and normal fimbria (the specialized ends of the tubes). Sometimes it is impossible to give even a reasonable estimate of success without examining the tubes through a “telescope”, a procedure called a “diagnostic hysteroscopy”, prior to tuboplasty. This is an outpatient procedure and does require general anesthesia. If this is necessary, Dr. Assad will discuss it with you.
By having a tubal repair, you also increase your chances of having a tubal pregnancy should you achieve one. If you experience a missed or abnormal period, or any of the signs and symptoms of pregnancy after a tubal repair, then you should consult the office immediately for a quantitative HCG (ultra-sensitive pregnancy test done of the blood).
Seriousness of the Operation
Tubal reversal is a major surgery and involves the same risks as any other operation, principally problems with anesthesia, infection, and hemorrhage. Because most patients who have this surgery are relatively young and in good health, complications are unusual. The operation may take from 1-3 hours and you may spend approximately 1-2 days in the hospital depending upon your progress. According to your lifestyle, tolerance for discomfort, and occurrence of complications, you will require 2 to 4 weeks convalescent period.Cost
Some insurance companies will pay most of the cost and others pay nothing. It is important to communicate with your insurance company directly to find out their position before you set a surgery date. The approximate cost of this surgery may vary depending on the length of the hospital stay, and any unforeseen complications. Your approximate cost of surgery, insurance coverage, and financial arrangements will need to be discussed with our Office Manager and Dr. Assad.
