Hysteroscopic cannulation for proximal tubal obstruction: a change for the better?

Kamalini Das, K Das, T C Nagel, Theodore C. Nagel, John W. Malo, J W Malo
Fertility and sterility · 1995 · vol. 63(5) , pp. 1009–1015 · doi:10.1016/s0015-0282(16)57539-6 · PMID:7720909 · W148738720
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This study investigated hysteroscopic cannulation as a treatment for proximal tubal obstruction to assess its efficacy and impact on patient outcomes.

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Abstract

OBJECTIVE: To compare overall the results of hysteroscopic tubal cannulations and resection anastomosis for proximal tubal occlusion. DESIGN: Nonrandomized retrospective analysis of patients operated on by two surgeons. SETTING: University and large tertiary referral private practice. PATIENTS: Seventy-four patients over a 10-year period, with bilateral or unilateral proximal occlusion of a single tube. INTERVENTIONS: Hysteroscopic cannulation, resection anastomosis, or both. MAIN OUTCOME MEASURES: Intrauterine and ectopic pregnancy rates, long-term tubal patency, and pathology of tubal segments. RESULTS: In patients with normal distal tubes, intrauterine pregnancy rates were similar (12/21, 57% versus 12/24, 50%) and ectopic pregnancy rates were lower (0/21, 0% versus 7/24, 29.1%) in the cannulation group. One-year patency rates in nonpregnant patients was higher in the anastomosis group (12/15, 80% versus 3/8, 33%). CONCLUSIONS: Hysteroscopic cannulation should be first choice in the management of proximal tubal obstructions in selected patients. It may be a treatment option for delayed occlusion after successful cannulation or resection anastomosis.

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MeSH descriptors

Catheterization Fallopian Tube Diseases Hysteroscopy Anastomosis, Surgical Fallopian Tube Diseases Fallopian Tube Patency Tests Female Humans Pregnancy Pregnancy, Ectopic Retrospective Studies

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