O. Martensson et al., SELECTIVE SALPINGOGRAPHY AND FLUOROSCOPIC TRANSCERVICAL SALPINGOPLASTY FOR DIAGNOSIS AND TREATMENT OF PROXIMAL FALLOPIAN-TUBE OCCLUSIONS, Acta obstetricia et gynecologica Scandinavica, 72(6), 1993, pp. 458-464
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.