TRANSCERVICAL RECANALIZATION OF STRICTURES IN THE POSTOPERATIVE FALLOPIAN-TUBE

PURPOSE: To evaluate use of transcervical recanalization in patients w ith reocclusion of the proximal fallopian tube after failed surgery to reverse sterilization or failed tuboplasty to treat inflammatory dise ase. MATERIALS AND METHODS: The standard technique for transcervical r ecanalization was attempted in seven patients after failed reversal su rgery and in 12 after failed tuboplasty. Four of seven patients with f ailed reversal surgery had fistular tracts and one also had a strictur e; the remaining three patients and all 12 patients treated after fail ed tuboplasty and tube reimplantation had strictures at the site of im plantation or anastomosis. RESULTS: Transcervical recanalization faile d in all patients with fistulas but succeeded in 13 of 15 with stenose s. Three patients became pregnant 1-16 months after recanalization and two after in vitro fertilization and embryo transfer. Reocclusion occ urred in two of 10 patients reexamined 6-36 months after recanalizatio n. CONCLUSION: Transcervical recanalization is recommended as an alter native to repeat microsurgical reimplantation or tuboplasty.