Nolan, W., & Whittaker, N. M. (2026). Tuboplasty. In Textbook of Minimally Invasive Gynecologic Surgery (pp. 280-286). https://doi.org/10.1201/9781003312109-33
Nolan W, Whittaker NM. Tuboplasty. In: Textbook of Minimally Invasive Gynecologic Surgery. 2026. p. 280-286. doi:10.1201/9781003312109-33
Nolan, William, and Naomi Whittaker. "Tuboplasty." Textbook of Minimally Invasive Gynecologic Surgery, 2026, pp. 280-286.
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UPMC Divine Mercy Women's Health
RRM Academy Synopsis
Tubal Surgery Can Restore Fertility As An Alternative To IVF
The chapter reviews tuboplasty, surgery to fix blocked or scarred tubes. It draws on published studies and the authors' own surgical experience. Pregnancy rates after tube-reversal surgery ranged from 42% to 49% in one review. A separate study found tube-clearing worked for most patients.
Key Findings
A meta-analysis of tubal reversal after sterilization found pregnancy rates of 42% to 49%, with ectopic pregnancy in 4% to 8% of cases.
In a meta-analysis of salpingostomy for hydrosalpinx, 27% of patients became pregnant, with an ectopic pregnancy rate of 10%.
Cited studies of adhesion removal for blocked tubes reported live birth rates of 37% to 57%, with ectopic pregnancy in 5% to 8% of cases.
Birth rates after distal tubal surgery reached 40% to 60% when the tubal disease was mild, but fell below 20% when it was severe.
Fluoroscopic cannulation for proximal tubal blockage succeeded in 71% to 92% of patients, with post-procedure pregnancy rates of 30% to 40%.
Interpretation
This chapter reviews studies on tubal surgery for infertility, plus the authors' own surgical experience. Tube-reversal surgery, tube-opening surgery, scar removal, and tube-clearing procedures all restored fertility for many patients. Results depended on how much tube damage was present before surgery. The authors say published tuboplasty research is limited. They describe their own preferred techniques, such as tissue handling and laser use, based on this experience. The findings support larger studies that compare tube repair with tube removal followed by IVF.
RRM Context
The chapter argues for repairing a damaged tube instead of removing it. The authors point to lower cost, the chance of more than one pregnancy without repeat treatment, and fewer risks tied to IVF pregnancies. That fits a core idea in restorative reproductive medicine: treat the cause. NaProTechnology-trained surgeons use the same repair and scar-prevention steps described here for endometriosis. The authors note that current guidelines still favor tube removal with IVF for older patients or those with other fertility problems, while allowing tube repair for others.
Our editorial summary of this paper, not the article's abstract.
