Hysteroscopy and the butyl-cyanoacrylate on experimental sterilization of rabbit uterine tubes

Abstract

Purpose:To assess the sterilization effectiveness on uterine tube of rabbit by the cyanoacrylate adhesive. Methods: Hysteroscopy tubal catheterization was performed randomly in 12 animals (24 uterine tubes) assigned to the sham group (GS) and 15 animals (30 uterine tubes) to the n-butyl-cyanoacrylate (GB). The female rabbits were observed during 30, 90 and 180 days and mated to fertile males. The no pregnant rabbits were submitted to in vitro burst pressure test for patency by air insufflation (40 mmHg). The microscopic assessment was performed to parameters of damages in epithelium caused by the adhesive, the degree of inflammatory process, morphometry data values of tube diameter (UT) (cm), mucosa thickness (MT) and the myosalpinx thickness (MyT) (mm). The mucosa cells densitometry (total optical density) was expressed by the amount of DNA. The significance of the differences in histological scores and in thickness measurements were made by ANOVA test (P value < 0.05). Results: In all animals of GB: the adhesive was attached to the mucosa; there was no pregnancy; no records of significant degree on inflammatory process; the patency test was negative and densitometry of DNA showed similar values to the both groups independently of observation periods. The layers thickness of GB-UT(1.118±0.117), GB-MT(0.447±0.247) and GB-MyT(0.853±0.097) were larger than the GS-UT(0.666±0.409), GS-MT(0.211±0.070) and GS-MyT(0.442±0.143). Conclusion: This approach offers a safe and feasible method of uterine tube obstruction. Key words: Sterilization, Reproductive. Tissue Adhesives. Fallopian Tubes. Rabbits. RESUMOObjetivo: Verificar a eficácia do adesivo de cianoacrilato na esterilização de tubas uterinas de coelhas. Métodos: A cateterização tubária por histeroscopia foi realizada randomicamente em 12 animais (24 tubas uterinas) formando o Grupo Sham (GS) e 15 animais (30 tubas uterinas) para o grupo do n-butil-cianoacrilato (GB). As coelhas foram observadas por 30, 90 e 180 dias e acasaladas com machos férteis. As tubas uterinas das fêmeas que não ficaram grávidas foram submetidas ao teste de pressão de rompimento in vitro, com insuflação de ar (40mmHg). A microscopia óptica estudou os danos causados ao epitélio pelo adesivo, o grau de processo inflamatório, a morfometria do diâmetro tubário (UT) (cm), da mucosa (MT) e do miosalpinge (MyT) (mm). A densitometria das células da mucosa (Densidade Óptica Total) foi expressa pela contagem do DNA. As significâncias dos diferentes escores histológicos e das medidas das camadas foram avaliadas pelo Teste de ANOVA (P<0,005). Resultados: Em todos os animais do GB: o adesivo estava aderido na mucosa tubária, não ocorreu prenhez, não houve significância nos graus do processo inflamatório, o teste de perviedade foi negativo e a densitometria do DNA apresentou valores similares em todos os grupos, independente do período de observação. A medida das camadas do GB-UT(1.118±0.117), GB-MT(0.447±0.247) e GB-MyT (0.853±0.097) foi maior que as dos GS-UT(0.666±0.409), GS-MT(0.211±0.070) e G...

Transcervical hysteroscopic sterilization using cyanoacrylate: A long‐term experimental study on sheep

“…Another patency postmortem test was performed by injecting 20 mL of methylene blue through the same double‐lumen catheter under pressure (80 mmHg). We then observed the eventual escape of the dye through the fimbriae 8,9 …”

“…The transcervical hysteroscopy instillation of n‐butyl‐2‐cyanoacrylate is an effective method of promoting of tubal occlusion in rabbits 6,7 . In sheep, over the course of 90 observation days, the adhesive was effective in ensuring sterilization 8,9 . In both animal models the adhesive plug remained intact in the tubal lumen and no macrophage cells were identified in optical microscopy visualization utilizing casts of the polymers inside.…”

“…The hypertrophy of myosalpinx may be associated with the effort invested in peristaltic movements to remove the adhesive plug. The mucosa remained intact, but it exhibited decreased thickness 6–9 …”

Design, Development and Validation of a Novel Mechanical Occlusion Device for Transcervical Sterilization

“…Transcervical sterilization is gaining more attraction because of its expediency and various advantages over tubal-ligation method [72]. Transcervical sterilization is also a comparatively less risky and more cost effective method [73] and generally performed in a clinical setup.…”

Hysteroscopic tubal occlusion using iso‐amyl‐2‐cyanoacrylate in patients with hydrosalpinx

“…Nevertheless, most noninvasive techniques did not produce satisfactory tubal occlusion, and/or produced serious side effects. Recently the use of cyanoacrylates (CAs), sclerosing agents, was found to be a safe and effective method of hysteroscopic uterine tube occlusion . Iso‐amyl‐2‐cyanoacrylate is a CA derivative, recently used successfully in obstructing digestive, urinary and pulmonary fistulas and for management of bleeding esophageal varices and gastric Dieulafoy's lesion, without serious complications …”