Role of Laparoscopy in the Management of Infertility Related to Tubo-Pelvic Pathologies in a Low-Resource Country in the Gynecology Department at Chupoint G Bamako / Mali

Abstract

Objective: The management of tubal infertility and related totubo-pelvic pathologies.

Methodology: Our study was carried out in the Gynecology department at CHU POINT G. It was a cross-sectional study during 09 years. Patients with infertilities due to tubo-pelvic pathology and who needed laparoscopy were included. The statistical tests used were Chi2; P ≤ 0.05 was significant.

Results:During our study, we recorded 14,200 internal consultations, of which 4,779 (33.7%) wanted to have children; 11,169 needed surgery, of which 628 (5.6%) laparoscopic surgery and 354 (3.1%) laparoscopic surgery for infertility.

STIs :52.3% (185/354) of our patients; those with a surgical history: 16.1% (57/354) were risk factors and there was a link between the occurrence of pregnancy after management and surgical history with Khi2: 5.97; P: 0.01. The causes were:tubal obstructions in 69.2% (245/354), hydrosalpinx: 25.4% (90/354) and pelvic adherences 70.1% (248/354) and there was a relationship between membership and fertility prognosis, adhesiolysis, tubal plasties, laparoscopic fimbrioplasty and the occurrence of pregnancy with respectively Khi2: 10.24 and P: 0.00 and Khi2: 28.95 and P: 0.00. This management enabled us to obtain 207 pregnancies, or 58.5%.

Conclusion: The frequency of tubo-pelvic infertility is very high in our series related to sexually transmitted infection; laparoscopy has an important role to play.