{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T23:13:12Z","timestamp":1768864392862,"version":"3.49.0"},"reference-count":47,"publisher":"Societatea Romana de Morfologie","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rom J Morphol Embryol"],"published-print":{"date-parts":[[2025,12,12]]},"abstract":"<jats:p>Background: Hydrosalpinx remains a major cause of female infertility, with Palmer-type neosalpingostomy representing a fertility-preserving alternative to salpingectomy in selected patients. While disease severity is a well-established prognostic factor, the contribution of endocrine and infectious comorbidities to reproductive outcomes after tubal reconstruction remains poorly characterized. Patients, Materials and Methods: This retrospective cohort study included 160 women with hydrosalpinx who underwent Palmer-type neosalpingostomy between January 2018 and December 2024 at Independen\u0163a VitaPlus Hospital, Craiova, Romania. Endocrine and infectious comorbidities were systematically assessed preoperatively, including polycystic ovary syndrome (PCOS), thyroid dysfunction, obesity, diabetes, pelvic inflammatory disease (PID), and urinary tract infections (UTI). Pregnancy outcomes were evaluated over a 24-month follow-up period. Statistical analysis included Kaplan\u2013Meier survival estimates and multivariate logistic regression to identify independent predictors of clinical pregnancy. Results: PCOS (30.6%), PID (28.2%), and UTI (18.1%) were the most common comorbidities. Hydrosalpinx severity was the only independent predictor of clinical pregnancy [odds ratio (OR) 0.38, p 0.001]. Although endocrine and infectious comorbidities did not reach statistical significance in multivariate models, Kaplan\u2013Meier analysis revealed observable prolongation in time-to-pregnancy for patients with PID, PCOS, or obesity. Increasing infectious burden (\u22652 pathogens) was associated with higher pelvic adhesion rates and reduced conception probabilities. Conclusions: Hydrosalpinx severity remains the main determinant of reproductive prognosis after Palmer-type neosalpingostomy. However, endocrine and infectious comorbidities exert clinically relevant negative effects, supporting a comorbidity-informed approach to patient selection and preoperative optimization. Prospective, multicenter studies with in vitro fertilization (IVF) comparison arms are warranted to refine prognostic models and optimize fertility counseling and treatment strategies.<\/jats:p>","DOI":"10.47162\/rjme.66.3.10","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T10:41:45Z","timestamp":1768819305000},"page":"533-543","source":"Crossref","is-referenced-by-count":0,"title":["An exploratory study on the impact of endocrine and infectious comorbidities on reproductive outcomes after Palmer-type neosalpingostomy"],"prefix":"10.47162","volume":"66","author":[{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren\u0163iu Augustus","family":"Barbu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolae Drago\u015f","family":"M\u0103rg\u0103ritescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliana","family":"Cercelaru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Anatomy and Embryology, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberiu \u015etef\u0103ni\u0163\u0103","family":"\u0162enea-Cojan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana Alexia","family":"\u0162enea-Cojan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"C\u0103luianu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Resident Physician, Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Florin R\u0103zvan","family":"Mogo\u015f","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stelian \u015etef\u0103ni\u0163\u0103","family":"Mogoant\u0103","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liviu","family":"Vasile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"26736","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"\"[1] Feng J, Wu Q, Liang Y, Liang Y, Bin Q. 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