SELECTIVE SALPINGOGRAPHY AND FLUOROSCOPIC TRANSCERVICAL SALPINGOPLASTY FOR DIAGNOSIS AND TREATMENT OF PROXIMAL FALLOPIAN-TUBE OCCLUSIONS

In 25 women with primary or secondary infertility, primary hysterosalp ingography (HSG) or laparoscopy with chromopertubation indicated 33 pr oximal and 2 distal tubal obstructions. Four salpingectomies had been performed earlier. All patients were considered for transcervical cath eter salpingoplasty (TCSP) to reconstruct tubal patency. Secondary exa mination with repeat HSG or selective osteal salpingography confirmed 26 proximal and 3 distal tubal occlusions while 17 tubes were patent. Selective osteal salpingography was performed successfully in 32 of 33 (97%) tubes. Sixteen of 26 (61.5%) proximally occluded tubes were suc cessfully recanalized by coaxial catheter and guidewire technique whil e two of three distally occluded tubes were reopened by forceful flush ing of contrast medium. So far, one ectopic and five intrauterine preg nancies were achieved in ten patients with observation time more than four months. Three patients have had normal deliveries. The favorable results, lack of complications and low costs seem to justify the recom mendation to use selective salpingography and fallopian tube recanaliz ation as the first intervention in patients with obstruction of the pr oximal fallopian tube.