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Results for “Fallopian Tube Patency Tests”

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PubMed1998

Magnetic resonance imaging with gadolinium-diethylenetriamine pentaacetic acid is useful in assessment of tubal patency in a patient with iodine-induced hypothyroidism.

A 32-year-old woman presented for evaluation of primary infertility. Because she had a history of iodine-induced hypothyroidism, conventional hysterosalpingography was contraindicated. Tubal patency was assessed by magnetic resonance imaging (MRI) after infusion of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). Visualization of the contrast medium in the peritoneal cavity revealed tubal patency. Our case indicates that MRI with gadolinium-diethylenetriamine pentaacetic acid is a safe, simple, and easy way to confirm that at least one tube is patent when a patient is at risk for hysterosalpingography. To our knowledge, this is the first report that tubal patency was diagnosed on MRI.

Adult↗

PubMed2001

Use of ethylene vinyl alcohol copolymer for tubal sterilization by selective catheterization in rabbits.

PURPOSE: To assess the efficacy of ethylene vinyl alcohol copolymer (Uryx) in nonsurgically occluding the fallopian tube and achieving tubal sterilization in the rabbit model. MATERIALS AND METHODS: Ten mature virgin female New England rabbits underwent transvaginal selective bilateral fallopian tube cannulation with use of a coaxial catheter system under general anesthesia. Selective salpingography was performed bilaterally to assess patency of the fallopian tubes. Ethylene vinyl alcohol copolymer was injected unilaterally through a microcatheter to completely fill the middle portion of the tube. Three to seven days after injection, each animal was bred. Conception was determined by ultrasonography (US) 7-19 days after effective breeding. If pregnant, the rabbit was killed. Otherwise, it was permitted to rebreed until pregnancy was achieved. Histologic specimens of the fallopian tubes were prepared and analyzed. RESULTS: Patency of the fallopian tubes was demonstrated bilaterally in all animals by the free spillage of contrast material into the peritoneum. The delivery of ethylene vinyl alcohol copolymer into the fallopian tubes was successful in all animals but one, in which most of the plug almost immediately extruded into the uterus. Pregnancy was detected by US in the untreated fallopian tube in the nine rabbits that were receptive to breeding. No pregnancies were detected in the injected side. Histologic analysis demonstrated variable degrees of occlusion, fibrosis, and inflammation, with the majority of specimens demonstrating mild to moderate inflammation and moderate to marked fibrosis. CONCLUSION: Ethylene vinyl alcohol copolymer can reliably be placed nonsurgically via the transvaginal approach into the fallopian tubes with use of a coaxial catheter system. Ethylene vinyl alcohol copolymer appears to result in less fibrosis than previously investigated agents and demonstrates a 100% early sterilization rate in the rabbit model.

Animals↗

PubMed2002

Intratubal methotrexate for prevention of persistent ectopic pregnancy after salpingotomy.

STUDY OBJECTIVE: To investigate whether frequency of persistent ectopic pregnancy after linear salpingotomy can be reduced by prophylactic administration of a single intraoperative injection of local methotrexate. DESIGN: Prospective, randomized, controlled trial (Canadian Task Force classification I). SETTING: University-affiliated hospital. PATIENTS: Sixty-five women with unruptured ectopic pregnancy. INTERVENTION: Laparoscopic salpingotomy with or without a single intratubal dose of methotrexate 1 mg/kg. MEASUREMENTS AND MAIN RESULTS: In the prophylaxis group, 22 patients received a single dose of intratubal methotrexate 1 mg/kg after linear salpingotomy; 43 controls had only linear salpingotomy. Six women (14%) in the control group developed persistent ectopic pregnancy, compared with none in the prophylaxis group (p <0.05). CONCLUSION: In our opinion, intratubal methotrexate injection during laparoscopic salpingotomy is a practical option for women with unruptured ectopic pregnancy.

Abortifacient Agents, Nonsteroidal↗

PubMed1995

Laparoscopic-assisted tubal anastomosis.

STUDY OBJECTIVE: To determine the length of procedure, length of hospital stay, complications, and postoperative pregnancy rates of traditional tubal anastomosis (TA) and laparoscopic-assisted TA (LATA). DESIGN: A comparison of 8 women undergoing LATA with 11 patients operated on by the same surgeon during a similar time period who were not candidates for, or did not desire, a laparoscopic approach. SETTING: Academic practice tertiary care setting. PATIENTS: Women requesting reversal of tubal ligation. INTERVENTIONS: Tubal anastomosis by laparoscopy or laparotomy. MEASUREMENTS AND MAIN RESULTS: Patients undergoing the two procedures did not differ by age or parity, although those selected for LATA had a lower body mass index (23.2 +/- 1.4 vs 30.8 +/- 2.0 kg/m2, p = 0.01). Although the LATA took longer (251 +/- 14 vs 194 +/- 10 min, p = 0.004), hospital stay was significantly shorter than for traditional TA (1.8 +/- 0.3 vs 3.0 +/- 0.1 days, p = 0.004). Of the eight LATAs, six were completed and two were converted to laparotomy. For all patients with follow-up, clinical pregnancy rates were 43% and 29% (NS) for TA and LATA, respectively, with 100% of the former and 80% (NS) of the latter group who did not conceive having at least one patent tube on hysterosalpingogram. CONCLUSIONS: Laparoscopic-assisted TA is a possible alternative to the traditional TA performed by laparotomy. Ideal candidates for LATA appear to be women without obesity and with proximal tubal segments of 3 cm or greater. Larger studies with longer follow-up will define appropriate candidates and identify long-term results.

Adult↗

PubMed1996

Tubal patency and conception rates with three methods of laparoscopic terminal neosalpingostomy.

STUDY OBJECTIVE: To determine the best method of laparoscopic neosalpingostomy for terminal tubal obstruction with respect to postoperative tubal patency and pregnancy. DESIGN: Three-year follow-up study. SETTING: University hospital. PATIENTS: Eighty-two women. INTERVENTIONS: Clubbed fimbriae were incised with scissors and sutured after eversion in 26 patients (type 1 procedure), and incised with needle diathermy and everted by endocoagulator without suturing in 27 (type 2). In 29 women the original fimbrial shape was restored by traction with grasping forceps after making a small hole with needle diathermy, and the fimbriae were sutured after eversion (type 3). MEASUREMENT AND MAIN RESULTS: Tubal patency rates on hysterosalpingogram 2 months after the three operations were 13 (50%) of 26 patients for type 1, 23 (85.1%) of 27 patients for type 2, and 28 (96.2%) of 29 patients for type 3. Tubal patency for types 2 and 3 was significantly higher than for type 1 (p <0.01). Conception rates within 3 years for the procedures were 5 (19.2%) of 26 women for type 1, 10 (37.2%) of 27 for type 2, and 14 (48.2%) of 29 for type 3. The conception rate for type 3 was significantly higher than that for type 1 (p <0.05). Especially when the operation was performed in women with favorable prognostic conditions, the conception rate was 9 (64.3%) of 14 women for type 3 operation. CONCLUSIONS: The type 3 procedure was the most effective method of laparoscopic neosalpingostomy for terminal tubal obstruction, especially when performed in patients with favorable prognostic factors.

Adult↗

PubMed1997

Correlation between salpingoscopic score and subsequent pregnancy outcome in patients with tubal infertility.

PURPOSE: This study evaluated the efficacy of the salpingoscopic scoring system of tubal function. METHODS: Twenty-seven infertile patients, including 10 patients with proximal tubal occlusion, 12 with endometriosis and 5 with inflammatory hydrosalpinx, were studied. All 54 tubes were examined using a 0.5-mm-diameter salpingoscope and scored. RESULTS: The mean scores for patients with proximal tubal occlusion, endometriosis, and inflammation were 18.6 +/- 2.0, 15.6 +/- 0.7, and 20.8 +/- 3.4, respectively. Eight patients (29.6%) conceived; their mean tubal score was 12.6 +/- 0.5 (12-16). Nineteen patients did not conceive, and their mean score was 18.8 +/- 1.4 (12-31). There was a significant difference between these two scores (P < 0.001). CONCLUSIONS: Scoring of the tubes by salpingoscopic examination is useful for evaluating tubal function with regard to prediction of pregnancy and also for selecting IVF or tubal reconstructive surgery as the preliminary treatment.

Endoscopy↗

PubMed2001

Assessment of Fallopian tube patency by HyCoSy: comparison of a positive contrast agent with saline solution.

OBJECTIVE: To compare the efficiency of air-filled albumin microspheres (Infoson) with saline solution in determining Fallopian tube patency during hysterosalpingo contrast sonography (HyCoSy). METHODS: This was a prospective randomized multicenter study with a sequential design. Over a 10-month period, 23 patients (mean age, 33 years) referred for infertility were examined by HyCoSy (saline or Infoson) before conventional hysterosalpingography (Iopamiron 370), performed during the same session. Contrast agents were administered through a 5-F Ackrad balloon catheter inserted transcervically into the uterine cavity. HyCoSy was performed with a 7-MHz transvaginal probe using both B-mode and color Doppler, and tubal patency was demonstrated by the appearance of contrast agent in the peritoneal cavity near the ovaries. Data were registered for each patient during the examination and the results were monitored by sequential analysis. RESULTS: Mean volumes of contrast injections were 35.3 mL of saline, 14.4 mL of Infoson, and 13.8 mL of Iopamiron 370. Infoson-enhanced HyCoSy provided a significantly larger (P = 0.006) number of correct diagnoses (20/22 Fallopian tubes) than did saline HyCoSy (12/24 Fallopian tubes), and the same number as that achieved by hysterosalpingography. CONCLUSION: A positive ultrasound contrast agent appears to be more efficient than saline solution at determining Fallopian tube patency in infertile women by means of HyCoSy, and as efficient as an iodinated contrast agent in the same population explored by HSG. HyCoSy could be used to screen infertile women, thereby avoiding the use of iodinated contrast medium and exposure to ionizing radiation during conventional HSG in patients with patent Fallopian tubes.

Adult↗

PubMed2000

Three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) as an outpatient procedure to assess infertile women: a pilot study.

OBJECTIVES: This study aimed to assess the use of three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) as a routine outpatient procedure for evaluating infertile women. METHODS: In 25 unselected infertile patients, tubal patency and uterine cavity were investigated by 3D-HyCoSy with saline as a contrast medium. The efficacy of the procedure was evaluated with X-ray hysterosalpingography (XHSG) as reference. RESULTS: The positive predictive value, negative predictive value, sensitivity, and specificity of predicting tubal patency by 3D-HyCoSy were 100, 33.3, 84.4, and 100%, respectively. The full contour of the uterine cavity was depicted in 96% of cases by 3D-HyCoSy and 64% by XHSG (P < 0.005). The uterine cavity area measured on 3D-HyCoSy correlated well with the volume of contrast medium required on XHSG (r2 = 0.8166). CONCLUSIONS: 3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women.

Adult↗

PubMed2002

The sonographic evaluation of tubal patency with stimulated acoustic emission imaging.

OBJECTIVES: Experimental and clinical data suggest that insonation of echo-enhancing contrast agents with high acoustic power produces disintegration of microbubbles, resulting in a phenomenon called stimulated acoustic emission (SAE). The purpose of this study was to investigate whether SAE might be detected by transvaginal sonography and whether this technique may be useful in the assessment of tubal patency by hysterosalpingo-contrast sonography (SAE-HyCoSy). METHODS: Patients booked for X-ray hysterosalpingography (HSG) for infertility evaluation also received SAE-HyCoSy. The order of the two procedures was established in each patient by randomization after placement of a transcervical balloon catheter. For SAE-HyCoSy, the ultrasound contrast medium Levovist was injected, with the acoustic power set at the maximum level permitted on ultrasound machines employing dedicated algorithms. Conventional HSG was performed for comparison. RESULTS: Seventy-seven Fallopian tubes were examined in 41 patients. In all cases it was possible to obtain the SAE phenomenon. In 10 tubes (13%) proximal filling was not observed by both SAE-HyCoSy and HSG. In the remaining 67 tubes, free spill from the distal end of the lumen was demonstrated in 96% of cases (64/67) with SAE-HyCoSy and in 97% of cases (65/67) with HSG. Disagreement between the two techniques was observed in five tubes only, with a Cohen's kappa coefficient of 0.76 (95% confidence interval, 0.56-0.96). CONCLUSION: SAE techniques were successfully applied to HyCoSy and allowed the visualization of the free spill of contrast agent into the peritoneal cavity in the majority of cases. SAE-HyCoSy showed good agreement with HSG in this preliminary study.

Acoustics↗

PubMed2006

Fallopian tube occlusion, an alternative to tubal ligation.

Diagnosis of fallopian tube pathology has been performed with X-rays, ultrasound, magnetic resonance imaging, and even nuclear medicine exams. However, fallopian tube interventions are almost exclusively the domain of fluoroscopy. Fallopian tube interventions can be divided into two categories: embolization and recanalization. The former has only recently been described using imaging guidance while the latter has been accepted as a safe and effective procedure since the early 1990s. This article will highlight the technique and results associated with fallopian tube embolization.

Fallopian Tube Patency Tests↗

PubMed1982

[Ultrasound diagnosis of pathologic changes of the uterine tube].

The possibilities of sonographic diagnosis of pathologic changes in the uterine tube are examined by means of a computerised automatic real-time scanner with a statistical B-scan of high resolution. It is not possible to isolate sonographically the anatomically unchanged tube or the tube obliterated as a result of salpingitis. Nevertheless, it is possible to effect an indirect diagnosis if the tube is at least unilaterally patent or if it is bilaterally occluded, by means of an extended form of sonography within the scope of a sonographically controlled hydropertubation via a phenomenon which the author describes an "positive" or "negative" "phenomenon of Douglas". Hence, sonographically monitored hydropertubation, together with hysterosalpingography or laparoscopic chromopertubation--with reservations--is a valuable diagnostic tool to help in clarifying the cause of sterility. Pathological changes of the tubes in the sense of a sactosalpinx of different contents (retained secretions) can be differentiated by sonography. A characteristic sonographic echo pattern is also seen if the tubes are conglutinated with an extremely low amount of liquid collected in the tube. Various pathological changes of the tube can be recognised sonographically directly and indirectly by means of sonography extended in this manner.

Diagnosis, Differential↗

PubMed1995

[Sterility as a sequela of tubal schistosomiasis].

A 21-year old african women presented with primary sterility in the outpatient department of our university hospital. Screening examinations, including ultrasound, demonstrated a tumour of 5.8 x 4.1 cm diameter on the left ovary. While performing laparotomy to extirpate this tumour, bilateral occlusion of the tubes was discovered by chromopertubation.This diagnosis led us to perform bilateral salpingostomy and reimplantation of the Fallopian tubes. In addition to the ovarian tumour (dermoid), fragments of the Fallopian tubes were sent for histological examination, which revealed eggs of schistosomes probably of the species Schistosoma haematobium. Since tourism to and immigration from endemic areas is increasing, schistosomiasis should be considered when it is not possible to elucidate the cause of sterility by classical means.

Adult↗

PubMed1991

[Treatment of fallopian tube pregnancies with prostaglandins].

In a study, the clinical use of prostaglandin F2 alpha in local and systemic application in women with ectopic pregnancies were studied (1, 9). Two different treatment schedules were defined and applied. In group A, patients with a diagnosed ectopic and beta-HCG level lower than 850 mIU/ml were treated with prostaglandin F2 alpha i.m. injected only. In group B, prostaglandin F2 alpha were injected in the chorionic cavity of the ectopic by laparoscopy after localisation with a thin needle. In spite of prostaglandin F2 alpha treatment, 6 of 30 patients (20.0%) had to be operated by microsurgery because of increasing serum beta-HCG levels. A control of tubal patency 6 month later showed one closed tube only (4.5%). Up to now, 8 spontaneous intrauterine pregnancies occurred in our study groups after successful prostaglandin F2 alpha treatment; one pregnancy was seen in a women with a single fallopian tube. The conserving treatment of one ectopic pregnancy using prostaglandin F2 alpha yields positive results, if serum beta-HCG levels are below 2000 mIU/ml.

Abortifacient Agents, Nonsteroidal↗

PubMed1990

[Is microsurgical preserving operation of tubal pregnancy sensible?].

During the period from 1976 to 1986, 179 women were operated at the Department of Gynaecology of the University of Düsseldorf. In 112 patients conservative techniques were used to retain the Fallopian tube. Of these 112, a group of 24 patients had a functioning adnexa on only one side at the time of operation. The conceptions of these women were investigated. In 8 of these patients, an intrauterine pregnancy occurred. 6 of these 8 patients had a salpingotomy, 1 woman underwent resection with immediate anastomosis and in another case both Fallopian tubes were treated (left Fallopian tube: reanastomosis status post resection three years earlier, right Fallopian tube: immediate anastomosis). 7 patients had a repeat ectopic pregnancy. Of these cases, direct anastomosis was performed 5 times and salpingotomy twice. 7 patients did not fall pregnant again. The Fallopian tubes of 6 patients were found to be open upon subsequent examination, while only one was found to be closed. One patient could not be followed-up, and one had neither a subsequent examination nor became pregnant again.

Adult↗

PubMed1990

[Transvaginal contrast hysterosalpingo-sonography with the B-image procedure and color-coded duplex sonography for the assessment of fallopian tube patency].

Transvaginal hysterosalpingo-contrast-sonography (HYCOSY), a new method for the direct assessment of tubal patency by means of ultrasonography, was employed in 68 women with infertility problems. In 67 cases, the findings were compared with hysterosal-pinography or chromolaparoscopy, performed either subsequently while the patient was still under the anaesthetic or later. The contrast demonstration of the Fallopian tubes was performed with the B mode procedure in 54 cases (Group 1) and by means of colour-coded duplex sonography in 14 (Group 2). In Group 1, the findings agreed completely in 39 cases, partially in 14 and not at all in one. In Group 2, in which 13 of the 14 cases were compared, the findings were identical in 9 cases and partially in 4. From the point of view of image documentation, the more vivid demonstration of free tubal passage in colour Doppler sonography compared to the simple B mode appears to be an advantage. Further studies are needed to determine whether contrast-perfused but dislocated tubes can be detected more easily and quickly with colour Doppler than in B mode.

Adolescent↗

PubMed1991

[The demonstration of the patency of the uterine tubes with color-coded duplex sonography in combination with ultrasonic contrast media].

Tubal patency was studied in 17 sterile women by means of colour-coded duplex sonography (CCDS) with local injection of an ultrasonic contrast medium. The results were compared with a conventional hysterosalpingogram. CCDS demonstrated all the soft tissues and their mobility. The ultrasonic contrast medium was SH U 454 (Schering). The colour signals generated by the air bubbles makes it possible to demonstrate tubal patency on both sides. The combination of an ultrasonic contrast medium and CCDS provides a simple, rapid, accurate and safe method for demonstrating tubal patency. Tubal patency can be demonstrated in the presence of anatomical complications and requires only a small amount of contrast medium.

Adult↗

PubMed1987

[Second-look laparoscopy--results and pregnancy rate in patients with a state of laparoscopically assessed acute adnexitis].

A report is given on the findings of second-look-laparoscopy in 229 patients with condition after laparoscopically ascertained and classified inflammations of the adnexes which were treated on the basis of uniform criteria. We also want to report about the pregnancy rate dependent upon the degree of severity of the inflammation in 121 patients. It could be proved with absolute certainty that there was a dependence of the frequency of pathologic changes of the tubes with negative chromopertubation on the degree of severity of the preceding illness and also on the kind of the causative organisms. The most frequent pathologic findings came up after advanced fibrinous-suppurative inflammations as well as after gonorrhoic inflammations of the adnexes, the latter not depending on the degree of severity. The pregnancy rate, 1-5 years after treated salpingitis, for patients having the wish to deliver a child, came to 72.5% after serous salpingitis, 72.2% after operation of the adnex on one side and 59.1% after fibrinous-suppurative salpingitis. In connection with the demand for general laparoscopic diagnostics of the inflammable illnesses of the adnexes it is important to point to the necessity of early registration and treatment as well as to the cultural diagnostics of gonorrhoea. In the case of abscesses of the adnexes on one side and wish to deliver a child immediate operation is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗

PubMed1989

[Initial experiences with hysterosalpingoscintigraphy in normal and pathologic fallopian tube passage].

A prospective study in 38 patients was designed to evaluate the efficacy and reliability of radionuclide hysterosalpingoscintigraphy (HSS) using 99mTc labelled human albumin macroaggregates (HAMA). Following application in the posterior vaginal fornix at the time of ovulation, HAMA normally migrate spontaneously through the uterus and tubes and may be identified after 20 min (range 5-90 min) in the uterine cavity and after 2 hrs (range 40 min - 3 hrs) in the free pelvis, using a gamma camera. When correlated with the findings of conventional contrast hysterosalpingography (HSG), the radionuclide procedure yielded comparable results in females with patent or clearly obstructed tubes. Using 8-10 MBq 99mTc, radiation exposure was estimated to be 0.75 cGy per ovary, which is considerably less than the mean dose absorbed with HSG. As the HSS procedure imitates the migration of spermatozoa by the means of an inert tracer, it allows a direct insight in the mechanisms of passive transport taking place in the uterus and tubes at the period of ovulation. Thus, it reflects the physiological state of the female reproductive tract. On the basis of the scintigraphic findings, equivocal results on HSG have to be re-evaluated, as tubes, which are anatomically patent under high pressure, may be functionally deficient.

Adult↗