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At least 163 records · Page 9Linked to original sources
PubMed1988

Preliminary experience with transcervical balloon tuboplasty.

We developed a new technique, transcervical balloon tuboplasty, an adaptation of established balloon angioplasty techniques that facilitates recanalization of proximally occluded oviducts. Sixteen patients with obstruction of the proximal portion of one or two fallopian tubes (based on at least two hysterosalpingograms and one laparoscopic examination) were selected for the procedure. Four patients (25%) were found to have patent oviducts on intraoperative third tubal patency evaluation and were therefore excluded from study. Of the remaining 12 patients, tubal patency was achieved in at least one fallopian tube in 7 patients (58%), as demonstrated by hysterosalpingogram immediately after the transcervical balloon tuboplasty procedure. On follow-up 2 months to 1 year afterward, two pregnancies and one delivery occurred. We conclude that transcervical balloon tuboplasty appears to represent a useful and safe technique to achieve patency in selected cases of tubal interstitial obstruction. Reocclusion rates, long-term complication rates, and pregnancy rates after transcervical balloon tuboplasty remain to be established before the procedure should be considered a recommended alternative for either surgical tuboplasty or in vitro fertilization.

Adult↗
PubMed1994

Technical report: fallopian tube recanalization--a simplified technique.

A simplified technique of fallopian tube catheterization is described in which the tube is recanalized with a guidewire alone. The technique has been used to treat 13 infertile women, age range 27-39 years (mean 32 years), with a diagnosis of proximal tubal obstruction. One tube was perforated; all other tubes were successfully recanalized. Three women conceived within 10 months of the procedure. The technique has results similar to the standard coaxial catheter method but is simple and quick.

Adolescent↗
PubMed2001

Tolerability of the mini-pan-endoscopic approach (transvaginal hydrolaparoscopy and minihysteroscopy) versus hysterosalpingography in an outpatient infertility investigation.

OBJECTIVE: To compare the acceptance and tolerability of the mini-pan-endoscopic approach (transvaginal hydrolaparoscopy [THL] combined with minihysteroscopy) versus hysterosalpingography (HSG) for evaluating tubal patency and the uterine cavity in an outpatient infertility investigation. DESIGN: Randomized controlled study. SETTING: University hospital. PATIENT(S): Twenty-three infertile patients without obvious pelvic pathology. INTERVENTION(S): Women were randomly divided into two groups. One group underwent minihysteroscopy and THL with tube chromoperturbation as first investigation and HSG within the following 7 days, while in the other group the investigation sequence was inverted. Women reported pain experienced before and at the end of procedures. MAIN OUTCOME MEASURE(S): Mean duration of procedures, level of pain experienced, diagnostic agreement about tubal patency and uterine cavity normality. RESULT(S): THL and minihysteroscopy took significantly more time but was significantly less painful than HSG. Regarding tubal patency, in 95.5% of cases THL agreed with HSG. In one case, HSG diagnosed a bilateral obstruction of tubes, whereas at THL a bilateral spreading of methylene blue was seen. Agreement on intrauterine pathologies between minihysteroscopy and HSG was poor (43%); the number of intrauterine abnormalities found at hysteroscopy was significantly greater than at HSG. CONCLUSION(S): THL in association with minihysteroscopy provided more information and was better tolerated than HSG in an outpatient infertility investigation.

Adult↗
PubMed2002

The learning curve of selective salpingography and tubal catheterization.

OBJECTIVE: To determine the effect of increasing experience in fluoroscopically guided selective salpingography and tubal catheterization on radiation doses and screening times, thus establishing a learning curve for the procedure. DESIGN: Retrospective case note analysis. SETTING: IVF center of an academic teaching hospital. PATIENTS: Three hundred sixty-six patients with infertility seen over 3.5 years. INTERVENTION(S): Fluoroscopically guided selective salpingography and tubal catheterization. MAIN OUTCOME MEASURE(S): Reductions in radiation doses and screening times for different categories of selective salpingography and tubal catheterization, expressed as percentage reductions during the study period and reductions per 10 procedures. RESULT(S): During the study period, The median dose of radiation decreased by 62.6%-71.9%, and the median screening time declined by 61.5%-78.5%. Reductions per 10 procedures were 2.5%-4.2% and 2.7%-5%, respectively. CONCLUSION(S): Significant reductions in radiation doses and screening times start early in a clinical team's practice of selective salpingography and tubal catheterization and continue even as trainees are added to the pool of operators.

Catheterization↗
PubMed1979

Treatment of female infertility due to tubal obstruction by operative laparoscopy.

The advent in recent years of safe endocoagulation (thermocoagulation within the abdomen) has permitted operative laparoscopic treatment of the tubal factor in infertility in selected cases. This paper reviews the results of operative laparoscopy in 223 cases treated for infertility between 1971 and 1976. Tubal occlusion was present in 133 patients before surgical intervention. Following operative laparoscopy, tubal patency was demonstrated in 67% on testing at the time of operation and in 12% at the first postoperative hydrotubation. In only 21% of cases was tubal patency not achieved by these methods. Those cases requiring isthmic salpingostomy, ampullary or isthmic-tubal implantation, or end-to-end anastomosis were further treated by laparotomy and microsurgery. Ninety cases of pelvic endometriosis were treated by a combination treatment of thermocoagulation, ovarian cyst resection, and the antigonadotropin agent, danazol. Ovariolysis, salpingolysis, fimbrioplasty, and salpingostomy can easily be performed using operative laparoscopy as the method of choice with a minimum of complications, shortened hospitalization time (2 days), and the potential for a repeat procedure or a follow-up laparotomy should this be necessary. The pregnancy rate following laparoscopic treatment for the correction of distal tubal occlusion was 30.5% and for endometriosis genitalis externa, 40%. These rates compare favorably with the rates following procedures involving laparotomy and microsurgery for correction of similar lesions.

Adult↗
PubMed1980

Experience in a series of fimbriectomies.

In a series of 247 consecutive sterilizations by fimbriectomy performed at the Denver General Hospital, a failure rate of 2.4% was found. The literature is reviewed, and these results are compared with results of other series. In several of the fimbriectomy series with more successful outcome, modifications of the technique originally described were used. The difficulties associated with the Kroener technique are discussed. The fimbriectomy failures were caused by either lack of resection of all of the fimbriae or the presence of tuboperitoneal fistulas, both congenital and acquired. Fimbriectomy should not be regarded as the method of choice for sterilization unless one can ensure adequate surgical exposure and complete removal of the fibria, including the fimbria ovarica.

Adult↗
PubMed1981

Hydrosalpinx: effect of oviductal dilatation on egg transport.

Ligation of the ovarian end of the oviduct was used to induce hydrosalpinges in rabbits and monkeys. This procedure resulted in an accumulation of clear serous fluid within the lumen and distention of the ampullary wall. The ampullary endosalpinx responded with a general flattening of the surface architecture, especially a decrease in the prominence of the longitudinal mucosal folds. However, this flattened epithelial surface showed normal ciliation. Two to five months after ligation, direct observations were made in vivo of luminal transport of cumulus egg masses and surrogates. These observations were followed by study in vitro of ciliary currents on the exposed luminal surface. The results demonstrated conclusively that tubal dilatation had no adverse effect on cilia-mediated ovum transport within the ampulla. The implication of these results in terms of tubal infertility is discussed.

Animals↗
PubMed1981

Mechanically-induced hydrosalpinx: long-term oviductal dilatation does not impair ciliary transport function.

Long-term hydrosalpinges were mechanically induced in rabbits by ligation of the fimbriated end of the oviduct. The structure and function of these model hydrosalpinges were studied 28 to 52 weeks following ligation. This procedure caused a nonpurulent, clear serous fluid to accumulate within the lumen of the ampulla, which resulted in dilatation of the ampulla and thinning of the tubal wall. The intraluminal mucosal folds were attenuated in the expanded regions; however, normal ciliation was predominant throughout the endosalpinx. Two rabbits, one with a single distal tubal ligation and the other with double ampullary ligation, showed abnormal epithelium with distinct patches of flattened polygon-shaped, nonciliated cells. In vivo and in vitro observations of luminal transport of surrogate ova in cumulus showed that ciliary transport was not affected by the long-term gross distension of the ampullae. The authors conclude that long-term tubal dilatation by itself does not alter tubal morphology sufficiently to impair ovum transport function in the oviductal ampulla.

Animals↗