Objectives

To collate the available evidence of the rare but identified late complications of mechanical tubal occlusion. The primary objective is to describe the nature of these longer-term acute presentations. Secondary objectives are: 1) to delineate their aetiology, 2) characterise imaging findings and 3) identify successful management options.

Study Design

Literature search using National Institute of Clinical Excellence Healthcare Databases Advanced Search and terms (complicat* OR torsion OR infect* OR migrat* OR extru*) AND (tubal occlusion OR sterili*). Results reviewed by CM and JH for eligibility.

Results

33 published case reports of long-term complications of mechanical tubal occlusion. 30 demonstrated migration of the device. 16 had infective pathology. Multiple modalities of imaging used with no clear evidence that one was superior. Medical and surgical management was used with removal of device proving definitive treatment.

Conclusions

Long-term complications of mechanical tubal occlusion are rare and show a varied clinical course. Clinicians should be mindful of this when evaluating patients in the acute setting, as there is no identified timeline as to when complications may occur. Imaging is almost always essential for diagnosis and the modality should be directed by the clinical presentation. Definitive management is by removal of the occlusive device, but this carries its own risks.

中文翻译：

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机械性输卵管阻塞远期并发症的系统评价

目标

整理关于机械性输卵管阻塞罕见但已确定的晚期并发症的可用证据。主要目的是描述这些长期急性表现的性质。次要目标是：1) 描述其病因，2) 表征影像学发现和 3) 确定成功的管理方案。

学习规划

使用 National Institute of Clinical Excellence Healthcare Databases Advanced Search 和术语（复杂*或扭转或感染*或迁移*或挤压*）和（输卵管闭塞或不育*）进行文献搜索。结果由 CM 和 JH 审查是否合格。

结果

33 发表了机械性输卵管闭塞长期并发症的病例报告。30 演示了设备的迁移。16 例有感染性病理学。使用多种成像方式，但没有明确证据表明其中一种方式更优。使用医疗和手术治疗，移除装置证明是最终治疗。

结论

机械性输卵管阻塞的长期并发症很少见，并且表现出多种临床过程。临床医生在评估急性情况下的患者时应注意这一点，因为没有确定何时可能出现并发症的时间表。影像学几乎总是诊断所必需的，检查方式应根据临床表现而定。最终的管理是通过移除闭塞装置，但这有其自身的风险。