Salpingitis Isthmica Nodosa: Technical Success and Outcome of Fluoroscopic Transcervical Fallopian Tube Recanalization

Houston, J. Graeme; Machan, Lindsay

doi:10.1007/s002709900207

Cited by 15 publications

(6 citation statements)

References 17 publications

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“…The authors concluded that FTR in SIN is associated with good results and, compared with previously reported results in unselected infertility patients, is associated with only a slightly less favorable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. 12 Proximal tubal obstruction caused by muscular, tubal or cornual spasms, viscid secretions, mucosal aggregates, amorphous debri or stomal edema can be managed by FTR with a good success rate. The FTR may not bear satisfactory results in cases with tubal obstruction secondary to endometriosis, chronic tubal edema or inflammation (Salpingitis) and cornual polyps.…”

Section: Discussionmentioning

confidence: 99%

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

Mohan

Sharma

Banode

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Infertility is defined as inability to conceive even after 1 year of unprotected intercourse. Tubal blockage is one of the common causes of primary as well as secondary infertility in females. Fallopian tube recanalization (FTR) an interventional radiological procedure is one of the most promising, effective, minimally invasive and cost-effective technique in patients having infertility owing to tubal blockage. The aim is to study the cause, hysterosalpingography findings, and outcome of fallopian tube recanalization by interventional radiological procedure in patients with tubal-blockage presenting with infertility.Methods: This was a prospective observational study of women with primary or secondary infertility presenting to interventional radiology department. The patients either had already undergone hysterosalpingography (HSG) or came for HSG. Fallopian tube recanalization was done as per institutional protocol. Hysterosalpingography abnormalities, outcome and complications of fallopian tube recanalization procedure were studied.Results: In this study of 87 patients unilateral or bilateral tubal blockages were seen in 16 and 24 patients respectively. Majority of the patients had Segment I proximal block. Bilateral recanalization could be successfully done in 12 patients (24 tubes) with bilateral Proximal Tubal Blockage (PTO). Unilateral recanalization was possible in 12 patients (tubes) with unilateral proximal block and 8 tubes with bilateral proximal tubal block. 10 tubes with PTO could not be recanalized. 5 cases diagnosed with bilateral Distal Tubal Block (DTO), recanalization was not attempted and were referred for appropriate gynecological management. Minor complications were noted in 8 patients while no major procedure related complications were observed.Conclusions: Fallopian tube recanalization (by interventional radiology procedure) in patients with fallopian tube blockage diagnosed on HSG is found to be cost effective, minimally invasive and have low complication rate. It is associated with excellent outcome in terms of technical success and improved conception rate.

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Section: Discussionmentioning

confidence: 99%

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

Mohan

Sharma

Banode

2018

Int J Reprod Contracept Obstet Gynecol

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“…9 Fallopian tube recanalization in SIN is technically successful and, compared with previously reported results in unselected infertility patients, is associated with only a slightly less favourable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. 10 We believe that this is the ®rst report describing the use of a 5-mm diagnostic hysteroscopic sheath, normal saline as distending medium, and a 0.018-inch Terumo hydrophilic guide wire along with a Labotect¯exible catheter guide cannula with a ball-shaped tip.…”

Section: Introductionmentioning

confidence: 89%

Hysteroscopic fallopian tube recanalization using a flexible guide cannula and hydrophilic guide wire

et al. 2000

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Objective To evaluate an innovative and simple procedure of hysteroscopic recanalization of cornual occlusion using a diagnostic hysteroscopic sheath, a Labotect flexible guide cannula and a Terumo hydrophilic guide wire, which were all used under laparoscopic guidance. Design In this prospective study, 17 patients with primary or secondary infertility with proven bilateral cornual blockage were scheduled for a recanalization procedure, between June 1995 and October 1998. Setting University-based teaching hospital and the principal author's private clinic. Subjects and methods We combined hysteroscopic cannulation of the proximal fallopian tube using a Labotect cannula with laparoscopic guidance in 17 patients with proximal tubal obstruction which had been diagnosed by hysterosalpingography and confirmed at laparoscopy. This procedure, in addition to being minimally invasive, also accomplishes the objective of causing minimal trauma to the fallopian tube by virtue of the dual hysteroscopic and laparoscopic guidance. Main outcome measures Successful on-table atraumatic recanalization of blocked fallopian tubes, documented by laparoscopic chromopertubation. Results Hysteroscopic cannulation could be attempted in 30 tubal ostia and was successfully accomplished in 15 cases. The instances in which we could not cannulate the tubal ostia (two patients) were not failures of cannulation but failures to visualize the internal tubal ostia because of thick endometrium. Four of our patients have conceived following this procedure and have delivered at term. Conclusion Hysteroscopic cannulation of the fallopian tube is a safe diagnostic procedure that can be used to identify those patients with true proximal occlusion, and may also serve as a therapeutic procedure in some of these patients. We recommend the use of a depot gonadotrophinreleasing agonist, such as triptorelin, 10±15 days before attempting this procedure, for easy visualization and access to the internal tubal ostia. The relative simplicity of the procedure means a shorter learning curve for clinicians in training and other beginners, and the results can be consistently reproduced as shown by the 15 successful cases in this study.

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“…An identified tubal disease such as salpingitis isthmica nodosa, or even tubal endometriosis, is not a contraindication [13]. The decision to undertake selective recanalization should ideally be taken following consultation between the radiology and gynecology department.…”

Section: Technique Of Hsgmentioning

confidence: 97%

Interventional radiology in female infertility: technique and role

Maubon¹,

Graef²,

Boncoeur-Martel³

et al. 2001

European Radiology

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The purpose of this paper is to describe the modifications in the radiologic approach to female infertility. The role of hysterosalpingography (HSG) has evolved from being the only source of information about the uterus to a more minor role, after ultrasound, that essentially deals with the morphology of the fallopian tubes. But if its diagnostic yield in the uterus is challenged by ultrasound and hysterosonography, it retains a major impact in the work-up of female infertility. Hysterosalpingography brings decisive diagnostic information concerning the state of the tubes and peritoneum. The interventional procedures of selective salpingography and tubal recanalization have a definite therapeutic effect and allow numerous pregnancies that would otherwise have required in vitro fertilization or tubal microsurgery.

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Salpingitis Isthmica Nodosa: Technical Success and Outcome of Fluoroscopic Transcervical Fallopian Tube Recanalization

Cited by 15 publications

References 17 publications

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

Fallopian Tube Recanalization (F.T.R): application of Interventional Radiology (I.R) post hysterosalpingography in management of female infertility at rural hospital

Hysteroscopic fallopian tube recanalization using a flexible guide cannula and hydrophilic guide wire

Interventional radiology in female infertility: technique and role

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