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Distal tubal obstruction is much more common (70%) than proximal obstruction. It can be caused by hydrosalpinges, pelvic adhesions, or fusion of the fimbriae. According to Schlaff et al, the presence of rugal pattern on HSG, the absence or presence of small hydrosalpinges less than 15 mm in diameter, the absence of significant pelvic adhesions, and the presence of identifiable fimbriae with patent ostium during laparoscopy were all associated with good prognosis following tubal reconstructive surgery106,107 About 80% of those women with mild tubal disease conceived. Patients with moderate and more severe disease had a much worse prognosis of achieving uterine pregnancy, and the risk of ectopic pregnancy was as high as 30% in some series.108 <a href=http://buymedsonline.org/products/buy-detrol-online.htm>have a peek here</a>
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