TRANSUTERINE TUBAL CANNULATION - A SAFE A ND EASY METHOD TO CHECK ON TUBAL PATENCY

In a prospective clinical study (March 89-June 91), we examined 114 in fertile women to evaluate the diagnostic value of transuterine tubal c annulation with the injection of sterile fluid and consecutive sonogra phical control in the assessment of tubal patency. The results of this technique were compared with the findings of laparoscopy and/or hyste rosalpingography. With the Jansen-Anderson Catheter (J-A-C) it was pos sible to reach the isthmic part of the tube without any analgesia or a naesthesia. 10 to 15 ml of sterile culture medium were injected. In ca se of tubal patency the fluid was detectable in the pouch of Douglas b y transvaginal ultrasound. In 108 out of 114 women (94.7%), the cannul ation of at least one tube was possible. All 97 patients with patent t ubes (laparoscopy) were diagnosed correctly via the J-A-C. The three c ases of proximal tubal occlusion were also diagnosed correctly, 8 pati ents with one or two-sided hydrosalpinx were also recognized. All five patients with bilateral hydrosalpinx were detected. Three women showe d a unilateral hydrosalpinx in the laparoscopy. In these cases the dia gnosis obtained by the J-A-C was once bilaterally patent and twice bil aterally distally occluded. Transuterine cannulation of the tubes with injection of sterile fluid and consecutive transvaginal sonography is an easy and safe method to evaluate the tubal status. It becomes poss ible thereby to prove tubal patency in a very early stage of diagnosti cs. Loss of time and futile treatment cycles (stimulations or insemina tions in cases of tubal occlusion) can thus be avoided.