Salpingotomy vs salpingectomy – a comparison of women’s fertility after surgical treatment of tubal ectopic pregnancy during a 24-month follow-up study

Abstract

Introduction: Ectopic pregnancy (EP) is usually located in the Fallopian tube and it has a significant adverse effect on women’s fertility. Three types of EP treatment include: expectant, medical, and surgical radical (salpingectomy) or conservative (salpingotomy) management. Objectives: The aim of the study was to compare women’s fertility after surgical radical or conservative treatment of tubal ectopic pregnancy. Materials and methods: Out of the 58 patients operated because of tubal EP pregnancy, 22 underwent laparoscopic salpingotomy (group 1) and 36 laparoscopic salpingectomy (group 2). EP-related data were obtained from medical documentation (the symptoms, diagnostic tests, EP risk factors, medical reproductive and surgical history, clinical status during EP surgery). Follow-up data were collected by means of a telephone interview. The survey included questions focused on women’s fertility during a 24-month period following the surgical treatment of EP (conception, subsequent intrauterine pregnancies and ectopic pregnancy). Results: A 24-month follow-up period revealed that the cumulative intrauterine pregnancy rate was higher in group 1 (salpingotomy) as compared to group 2 (salpingectomy), i.e. 50% vs. 41.5%, respectively. Tubal EP returned in 13.6% cases (group 1) vs. 19.4% (group 2). All submitted results are statistically insignificant. Conclusions: Our findings are consistent with the literature which reports a trend of higher odds for intrauterine pregnancy after salpingotomy for surgical treatment of EP as compared to salpingectomy. Moreover, the risk for recurrent tubal EP is comparable for both methods. Regardless, the decision about the operating range in case of EP always depends on the actual clinical state of the patient.