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KMID : 0358419920350071045
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Korean Journal of Obstetrics and Gynecology
1992 Volume.35 No. 7 p.1045 ~ p.1053
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Transcervical Fallopian Tube Catheterization for Proximal Tubal Obstruction
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노성일/Rho SI
강서옥/권혁찬/조정현/박종민/이승재/이도연/조병제/Kang SO/Kwon HC/Cho JH/Park JM/Lee SJ/Lee DY/Cho BJ
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Abstract
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The obstruction of the proximal fallopian tube occurs in 15% of hysterosalpingograms(HSG) performed for infertility. Conventional HSG or laparoscopy may not differentiate the cornual spasm or other temporary causes from true occlusion. We used the transcervical cannulation of the proximal fallopian tubes with a 3-F teflon catheter and a flexible guidewire, 0.015 inch(0.038 cm) in diameter muder the hysteroscopic or fluoroscopic guidance to evaluate and treat the patients with proximal fallopian tube obstruction. Fifty eight patietns with obstructions of the proximal portion of one or two fallopian tubes based on a hysterosalpingogram or a laparoscopic examination were selected for the procedure. Twelve patietns found to have patent oviducts by the selective salpingogram & the selective chromopertubation were therefore excluded from this study. Tubal patency of at least one fallopian tube was achieved in 27 patients(51 tubes), as demonstrated by hysterosalpingogram immediately after the transcervical cathterization procedure. The success rate of recanalization was 62.5%(35/56 tubes) under fluoroscopy and 66.7% (16/24 tubes) under hysteroscopy. In a mean follow-up of twelve months (range: from 8 months to 17 months), eight women with patient tubes after the procedure became pregnant. We conclude that transcervical catheterization appears to represent a useful, less invasive and safe technique to achieve patency in selected cases of proximal tubal obstruction.
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