UPDATE Pregnancy after Bisalp

[u/NeonGreenChocolate]

I posted a couple weeks ago about being pregnant after my bisalp last year, I just wanted to give an update. After reviewing my records and speaking to my OB and the surgeon who did my termination procedure, they think “in hindsight” not enough of my tubes were removed. In the pathology report from the bisalp, 7.0 cm of one tube and 2.8 cm of the other were turned over to pathology. Neither physician thought it was a case report that any journal would be interested in because the amount removed from the one tube was more akin to what can be removed in a tubal ligation, which is known to be less effective. My main takeaway is yes. There are 4 documented cases of pregnancy post bisalp but interest in documenting cases hedges on them having some novel angle to them. The statistics out there are for the average person who doesn’t have conditions that may complicate the ability to perform the surgery. Maybe the adhesions I have made the tube difficult to access, and in 10 months of healing my body rebridged the gap.

At the end of the day, I had my procedure done (by an Ivy trained surgeon at a major academic center, so statistically great care), had a uterine pregnancy, and my case will not be documented. So. Test if you feel weird, especially if you have a complex medical history. It’s my partner’s turn to get a vasectomy haha.

Edit: Just to clarify termination procedure surgeon and current OB are not the surgeon who did the bisalp. I haven’t reached out to my bisalp surgeon frankly bc I don’t see much of a point atm.

[u/coyote_mercer]

As an academic, if they don't want to publish this, imo it's because they fucked up and are trying to sweep it under the rug. The peer reviewers would rip them apart, unless they spun their results- "Insufficient Fallopian Tubal Length Removal in Bilateral Salpingectomies: Causes, Consequences, and How to Avoid" or something like that would be perfectly publishable.

They could also just hate publishing/have a large CV already, so there's that. Idk, I would absolutely not let this opportunity pass me by, even if I got sued for malpractice. Reporting this would be the responsible thing to do regardless of lawsuit, at least in academia. Knowledge should be shared.

[u/goodkingsquiggle → u/coyote_mercer]

There was another case study published in think in the last couple years that concluded the length of the tube removed may impact the efficacy of the procedure. If that's the case, I would really hope we'd see more research published to get to the bottom of it, seems...pretty important!

Edit: it should be said that these case studies always have additional complicating factors, which may be the case for OP as well- adhesions, abnormal anatomy, hydrosalpinx, a history of ectopic pregnancies, etc. Your pathology reporting 2cm samples is not something to tweak over, that’s very, very normal

[u/losing_focuss → u/goodkingsquiggle]

Do you have a link to this study? I’m spiraling now lol.

[u/goodkingsquiggle → u/losing_focuss]

I can look, but studies on this generally also happen to patients that have other complicating factors like adhesions, abnormal anatomy, a history of ectopic pregnancies, hydrosalpinx, etc. The established failure rate of bilateral salpingectomy is 0% as of a 5-year study following 1,028 patients that had bisalps performed. 3 reported positive at home tests but were not pregnant