[Statistical study of the factors influencing the prognosis in tuboplasty operations. Importance of the status of the ampullary mucosa and of chlamydial infection].

In a consecutive series of 508 tuboplasty operations, the actuarial figures for pregnancy after 2 years was 74% for proximal sutures, 27% for repeat terminal plastic operations and 42% for primary terminal plastic operations. A statistical study of the factors influencing these results was carried out with a multivariate analysis. This showed what factors determine the results. Some of these were already known (such as the extent of the tubal lesions, the state of the ampullary mucosa and the degree of adhesions); and the importance of active chlamydial infection was confirmed by the finding of positive pelvic cultures. These reduced significantly the levels of success even in anatomically favourable cases where the tubes were not completely blocked (24% if the cultures were positive and 64% if the cultures were negative, P less than 0.001) and if the ampullary mucosa was normal on salpingoscopy (21.6% successes if the cultures were positive and 64% if negative, P less than 0.001). A therapeutic strategy should be worked out for any operation in order to 1) select the best cases and 2) eradicate C. trachomatis before surgery.