TITLE:
Role of Laparoscopic Surgery in the Management of Female Infertility at the Department of Gynecology of Hôpital du Mali
AUTHORS:
Mamadou Bakary Coulibaly, Alassane Traoré, Mody Abdoulaye Camara, Bourama Kané, Adama Sangaré, Kalba Tembiné, Ibrahima Tégueté, Youssouf Traoré
KEYWORDS:
Laparoscopic Surgery, Infertility, Hopital du Mali
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.10,
October
26,
2020
ABSTRACT: Infertility
is a socio-cultural drama in Africa, especially in Mali and remains difficult
for couples to overcome. Laparoscopy, also called minimally invasive surgery or
keyhole surgery, is an operative technique that permits to explore the pelvis
and perform an appropriate therapeutic procedure. The objective of our work was
to assess the role of laparoscopic surgery in the treatment of female
infertility at Hopital du Mali. It was a retrospective descriptive study that
was conducted over a period of 5 years (January 2013 to December 2018). Any
patients followed for infertility and who underwent laparoscopic surgery in the
gynecology department over a period of two (2) years were included. The outcome
of laparoscopic surgery was evaluated in terms of conception of pregnancy. We
had collected 103 infertile patients out of 2984, with a frequency of 3.45%.
The mean age of our patients was 30.2 years. Housewives and out-of-school women
accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%.
Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with
an average duration of 6.2 years. Systematic chlamydial serology was positive
in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal
obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of
cases. Adhesiolysis was the main procedure performed with 84.47% bilateral
tubal patency achieved in the methylene blue test. Among our patients who had
contracted a pregnancy (22.99%), 85% had carried their pregnancies to term.
Tubal damage was the main cause of infertility. Adhesiolysis remains the main
laparoscopic procedure for treatment.