TRANSVAGINAL RECANALIZATION OF OCCLUDED FALLOPIAN-TUBES

Transcervical selective salpingography and transcervical recanalizatio n of obstructed tubes by bougie dilatation are advocated for diagnosti c assessment and therapeutic correction of obstructive lesions of the fallopian tubes. Premedication with aspirin (a prostaglandin antagonis t) proved normal patent tubes in 82 of 400 patients, referred with the diagnosis of obstruction of both fallopian tubes on hysterosalpingogr ams. In another 131 patients, selective salpingograms proved one (n = 93) or both (n = 38) tubes to be patent. Premedication with a prostagl andin antagonist and selected salpingography proved the obstruction to be functional in nature in more than one-half (213/400) of the patien ts. In 133 of the remaining 187 patients, recanalization via the trans cervical approach was possible. Forty-two of these patients became pre gnant. Selected salpingography is recommended as a highly effective pr ocedure to diagnose functional obstruction and allow assessment of the distal tubes not previously demonstrated. Transcervical recanalizatio n by bougie dilatation of strictures or obstruction is a highly effect ive and relatively inexpensive intervention that can correct most obst ructive lesions of the proximal tubes and make pregnancy possible in a pproximately one-third of the patients. The intervention has a very lo w risk of complication. The existing risk of tubal pregnancy must be m onitored by ultrasound in early pregnancy.