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PubMed1991

Selective injection of contrast media: inflammatory effects on rabbit fallopian tubes.

The inflammatory effects of fallopian tube catheterization and selective injection of seven contrast agents (ethiodized oil, diatrizoate meglumine 52%, diatrizoate meglumine 66%, iothalamate meglumine 60%, iopamidol, ioxitol, and ioxaglate) were evaluated in 88 rabbits. The contrast agent used was randomly selected and selectively injected after unilateral catheterization; the contralateral side was used for control. Pathologic inspection of right and left uteri with attached fallopian tubes and ovaries was done without knowledge of side of catheterization or duration of time since catheterization. The degree and location of inflammation were noted. Inflammation disappeared by 4 days in five of seven contrast agents. Iothalamate meglumine 60% and iopamidol required 2 weeks for disappearance of inflammation. Essentially no inflammation was associated at any time with ioxaglate. These findings suggest that all of these contrast agents would be clinically acceptable for direct injection into the human fallopian tube.

Animals↗
PubMed1992

Transcervical access and intra-luminal imaging of the fallopian tube in the non-anaesthetized patient; preliminary results using a new technique for fallopian access.

A study was performed to evaluate a new transcervical, Fallopian tube access system for use in falloposcopy procedures without the need for conventional hysteroscopy or uterine distension. Visualization was accomplished by the use of a 0.5 mm falloposcope which was delivered to the Fallopian tube by a new linear everting catheter. The linear everting catheter allows access to the Fallopian tube by means of a flexible, tubular rolling membrane which can safely negotiate the tortuous anatomy from the ostium to the ampulla. Concurrent laparoscopy was performed solely for supervision purposes and not for tubal manipulations in 13 Fallopian tube access procedures in 10 patients. The ostia were visualized in 12 cases and the Fallopian tube was accessed in all 12 without complications. As a precursor for future gamete and embryo transfer procedures, intra-tubal insemination was performed by visualizing the ostia, accessing the Fallopian tubes, and obtaining successful isthmic-ampullary, intra-luminal images.

Catheterization↗
PubMed1979

Bicornuate uterus and partial atresia of the fallopian tube.

Partial atresia of the fallopian tube was discovered in two patients with double uteri of the bicornuate variety. The abnormal tube in each case was ipsilateral to a noncommunicating, nonfunctioning, rudimentary uterine horn. A normal fimbriated end led to a short, patent ampullary portion that ended blindly in the mesosalpinx. Realization of the potential for the coexistence of congenital malformation of the fallopian tubes with various uterine malformations suggests that extreme caution be exercised during adnexal surgery in patients with anomalous development of the müllerian ducts.

Adolescent↗
PubMed1991

Selective fallopian tube canalization.

Infertility is an increasingly common problem. Occlusion of the fallopian tubes is one of the principal causes, and until recently surgery was the only available treatment. The success rate of surgery is often low, particularly with occlusion of the proximal tube. Selective fallopian tube canalization under fluoroscopic guidance has been successful in alleviating proximal tubal obstruction. This procedure may be performed in the outpatient setting and is a safe, cost-effective alternative to surgery.

Adult↗
PubMed1990

Nonsurgical fallopian tube recanalization for treatment of infertility.

Fluoroscopic transcervical fallopian tube recanalization was performed in 100 consecutive patients with infertility and proximal tubal obstruction documented with hysterosalpingography. In 86 patients, the procedure enabled at least one tube to be opened. Twenty-six intrauterine pregnancies resulted from the successful recanalization. A well-defined subset of 20 patients were evaluated to better define the treatment effect of fallopian tube recanalization. All 20 had bilateral proximal tubal obstruction without other tubal disease, and all had been recommended for tubal microsurgery or in vitro fertilization. Recanalization of one or both tubes was successful in 19 of these women (95%). Nine patients conceived (47%) without receiving any other therapy, and the average time from procedure to conception was 4 months. All pregnancies were intrauterine. Eight of the 10 patients who did not conceive underwent follow-up hysterosalpingography an average of 6 months following the procedure; four (50%) demonstrated reocclusion of both tubes. The authors conclude that nonsurgical fallopian tube recanalization is an effective treatment for infertility caused by proximal tubal obstruction.

Adult↗
PubMed1990

Effects of contrast agents on the fallopian tube in a rabbit model.

The authors evaluated the effect of different iodinated contrast agents on the fallopian tube and adnexal tissue in 15 rabbits. Ethiodized oil, an oil-soluble agent, was used in five rabbits. The following water-soluble agents were used: iothalamate meglumine 30% (n = 3), iothalamate meglumine 60% (n = 3), and ioxilan (n = 4). The agents were injected through catheters placed in the fallopian tubes. Fallopian tubes and peritoneal cavities were histologically evaluated. The contralateral tube served as a control. Ioxilan and iothalamate meglumine 30% produced no pathologic response in the tube or peritoneal cavity. Iothalamate meglumine 60% was associated with mild inflammatory infiltrate, mucosal edema, giant cell reaction, and periovarian adhesions that were bilateral but more pronounced on the injected side. Use of ethiodized oil resulted in papillary fibrous adhesions on the ovarian surface, and fat granulomas were seen in the periovarian tissues. The safety of oil-based contrast agents for use in hysterosalpingography is therefore questioned. No significant differences were found among the water-soluble contrast agents.

Adnexa Uteri↗
PubMed1978

Carcinoma of the fallopian tube.

Carcinoma of the fallopian tube is the least frequent tumor of the female genital tract. It may occur at any age but is more common in the sixth decade. The tumor involves both tubes in 26 per cent of cases. The spread is by direct extension to peritoneum. The symptoms include metrorrhagia, leukorrhea, abdominal pain, singly or in combination. The diagnosis is difficult but could be made more frequently if the causes of abnormal bleeding were thoroughly investigated by means of cytology and endometrial curettage. Treatment is by resection of the tumor, total hysterectomy, and bilateral salpingo-oophorectomy followed by chemotherapy. The 5-year survival rate is 38 per cent.

Adult↗
PubMed1989

The presence and estrogen control of immunoreactive calbindin-D9k in the fallopian tube of the rat.

The present study was undertaken to localize and investigate the endocrine control of immunoreactive 9K calbindin-D9k in the fallopian tube (oviduct) of the rat. Rat fallopian tubes were excised with the uterus, immediately fixed by freeze-substitution, and processed for immunoperoxidase staining. Staining employed a rabbit antiserum against purified rat intestinal calbindin-D9k and the streptavidin-biotin technique. Calbindin-D9k immunoreactivity was localized to luminal epithelial cells of the fallopian tube of mature rats, with no staining observed in other tissue layers of the tube. Epithelial cells in both the isthmus and the ampulla were positive for calbindin-D9k. In weanling rats, which have little ovarian function but high levels of 1,25-dihydroxyvitamin D, no immunoreactive calbindin-D9k was observed in any part of the tube. However, after daily injections of estradiol (6 micrograms/day) for 3 days, intense staining was observed in the epithelial cells of the immature rat fallopian tube. Progesterone treatment (1 mg/day for 3 days) of immature rats had no effect on calbindin-D9k in fallopian tube. The lumen of the fallopian tube (oviduct) is the key location for fertilization, a process that requires a narrowly defined concentration of extracellular calcium. By analogy to the intestine, calbindin-D9k may play a role in the transcellular movement of calcium across the fallopian tube epithelium in the fallopian tube lumen.

Animals↗
PubMed1986

Localization of gonococcal lipopolysaccharide and its relationship to toxic damage in human fallopian tube mucosa.

An experimental model using human fallopian tubes in organ culture was used to study the localization of purified gonococcal lipopolysaccharide (LPS). LPS was visualized by light microscopy with immunoperoxidase staining. Immediately after addition to fallopian tube organ cultures, gonococcal LPS aggregated on the tips of cilia. By 1 to 2 h after exposure, LPS could be seen distributed throughout the cytoplasm of ciliated and nonciliated cells in structures resembling vesicles. By 12 h, there were sloughed, ciliated cells present in the fallopian tube lumen, which had positive LPS stain on their surfaces as well as in their cytoplasm. By 24 h, LPS was distributed throughout the cytoplasm. Control experiments with rabbit oviduct organ cultures showed that LPS failed to attach, enter, or damage mucosal cells. These studies illustrate the initial localization of LPS on human mucosal cells and its uptake into the cells, which are coincident with toxicity for ciliated epithelial cells.

Animals↗
PubMed1976

Completed pregnancy following vascularized heterotopic autotransplantation of the Fallopian tube in the ewe.

Transplantation of the Fallopian tube is a technically feasible operation. Previous authors have reported pregnancies following turbo-ovarian transplants, but there appears to be no record of gestation following transplantation of the isolated oviduct. This communication illustrates the method that we have used to perform Fallopian tube transplants in the ewe and documents our first full-term pregnancy following this operation. It provides further evidence of the technical feasibility of Fallopian tube transplants.

Animals↗
PubMed1991

Unexplained displacement of ipsilateral ovary and fallopian tube.

During routine laparoscopy, the right fallopian tube and ovary were noted to be displaced. Ovarian and fallopian tube tissue were found on biopsy of adjacent omentum. The most probable cause is asymptomatic torsion of the right adnexum; therefore, evaluation of the renal system with intravenous pyelogram is probably not necessary.

Adnexal Diseases↗
PubMed1979

[Regeneration of the Fallopian tubes following sterilization (author's transl)].

After any trauma to the fallopian tubes by a sterilizing operation, pregnancy occurs. If the sterilizing procedure was by high frequency current coagulation, large areas of the fallopian tube must be destroyed down into the mesosalpinx in order to avoid the preprogrammed recanalization tendency of the muellerian duct. Fertilization has occurred in recanalized fallopian tubes which only showed a cubic epithelium. Extensive destruction of the fallopian tube is today not justifiable because of the possibility of interference with the ovarian blood supply and subsequent hormonal damage. At present the safest method of female sterilization is by tissue coagulation of segment of the fallopian tube at 100 centigrade and division of the coagulated portion. In 1000 cases there were no pregnancies.

Electrocoagulation↗
PubMed1991

[Experimental and clinical study of tong jing bao and Angelicae complex injection in treating fallopian tube obstruction].

Twenty-two female rabbits with fallopian tube obstruction as the model, were made by 25% Phenol-Tragacanth Mucilage in the laboratory study. Eight rabbits were treated by taking Tong Jing Bao and giving transcervical intrauterine injecting of Angelicae complex injection. Seven were treated with the latter and other seven with 0.9% saline only as the control group. The study showed that in the opening fallopian tube, anti-inflammation, limiting the hyperplasia of fibro-connective tissue and improving the regeneration of epithelial tissue, the first group was more effective than the other two groups (P less than 0.05). Forty-eight infertile women, in whom the fallopian tube obstruction were proved by hysterosalpingography, were divided into two groups for the clinical study. Thirty patients were treated as same as the first group of rabbits. As the control group, other eighteen women were treated with transcervical intrauterine injecting of gentamycin and 0.9% saline in 3 to 6 months. The effective rates were 94.6% and 56.6% (P less than 0.01) and the subsequent pregnancy rates were 46.7% and 27.8% respectively in the different two groups.

Adult↗
PubMed1990

Treatment of fallopian tube carcinoma with cisplatin, doxorubicin, and cyclophosphamide.

Primary carcinoma of the fallopian tube is uncommon and is often treated using regimens active in ovarian carcinoma. Evidence is scant that such therapies benefit patients with fallopian tube carcinoma. Between December 1979 and July 1988, we treated 18 patients who had adenocarcinoma of the fallopian tube with the combination of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2) administered intravenously on 1 day every 28 days. Histologic confirmation of fallopian tube carcinoma was obtained before entry in the study. Three patients had stage I disease, five had stage II, nine had stage III, and one had stage IV. Sixteen patients received the combination therapy as first-line treatment after cytoreductive surgery, and two patients received it for recurrent carcinoma. Seven patients had clinically measurable disease at the start of therapy. Two of these patients had a complete clinical response, two had stable disease, and three had progressive disease. Eight of the 15 patients with stages II-IV disease underwent second-look laparotomy; four had a complete response to therapy and four had a partial response, making the overall response rate 53%. The toxicity of the regimen was moderate. The median survival was 81 months. Patients with stages II-IV disease had a median survival of 43.9 months and a progression-free survival of 22.5 months. This regimen appears to be active in fallopian tube carcinoma and can result in response rates comparable to those reported for epithelial ovarian cancer.

Adenocarcinoma↗
PubMed1990

Fallopian tube cancer. The Roswell Park experience.

Sixty-four patients with primary fallopian tube cancer treated at Roswell Park Memorial Institute from 1964 to 1987 underwent retrospective clinicopathologic review. In 40 patients fallopian tube cancer was the only primary, but in 24 patients primary fallopian tube cancer was part of a multifocal upper genital tract malignancy. Of the 40 patients with unifocal fallopian disease, the median survival was 28 months. Only 15% of patients were alive and disease free with follow-up ranging from 22 to 141 months (median, 90.5 months). Survival was not associated with stage of disease, tumor histology, grade, or depth of invasion in this series. Fourteen patients who received cisplatin-based chemotherapy were evaluable for response. Three patients (21%) responded; two complete and one partial. Twelve patients without clinical evidence of disease underwent second-look procedures, ten laparotomy and two laparoscopy. Four of ten second-look laparotomies were negative. Secondary debulking was done in three of four patients with gross disease, one of which had a negative third-look laparotomy. Negative laparotomy, second-look or third-look, was associated with improved survival (P = 0.016). One of the two laparoscopies was negative, but the patient recurred. In the remaining 24 patients cancer of the fallopian tube was part of a multifocal upper genital tract malignancy. In 12 patients tubal disease was invasive, and in 12, it was in situ. Separate primaries occurred in the ovaries (n = 20); uterus (n = 7); and cervix (n = 2). This represents 1.3% of ovarian malignancies treated at Roswell Park Memorial Institute during the study period. Fallopian tube cancer seems as virulent as ovarian cancer with few long-term survivors. It is frequently associated with other sites of upper genital tract malignancy. Second-look laparotomy is an important predictor of survival. Second-look laparoscopy may be useful if positive.

Adenocarcinoma↗
PubMed1989

Carcinosarcoma of the fallopian tube.

A patient with Stage III fallopian tube carcinosarcoma treated with cisplatin, doxorubicin, and cyclophosphamide, surviving 31 months disease-free after diagnosis, is presented. Review of the literature revealed this is the 28th case report of malignant mixed Mullerian tumor of the fallopian tube, and fifth instance in which chemotherapy was used as a primary therapy. Modern chemotherapy appears to have improved survival.

Aged↗
PubMed1991

Selective salpingography and fallopian tube recanalization.

Obstruction of the uterine (proximal) end of the fallopian tube is noted on up to 20% of hysterosalpingograms and has a variety of underlying causes. Definitive diagnosis and treatment in the past have required laparoscopy or laparotomy with tubal resection. Selective salpingography and fallopian tube recanalization with fluoroscopically guided catheters has emerged as an improved method both for diagnosis and treatment in these patients. Technical success rates for overcoming the obstruction and visualizing distal tubal anatomy range from 76% to 95%. Pregnancy rates after the procedure vary depending on the patient populations studied; however, early results indicate a greater than 50% intrauterine pregnancy rate by 1 year. The rate of ectopic pregnancy is approximately 10% and that of early tubal reocclusion is less than 30%. Selective salpingography and fallopian tube recanalization is recommended as the first intervention in patients with obstruction of the proximal fallopian tube.

Catheterization↗
PubMed1976

In vivo motility of the unobstructed fallopian tube.

Current methods of recording the fallopian tube motility in vivo essentially measure the intraluminal pressure. Diametral change is another parameter which can provide additional useful information related to tubal function. A method for in vivo monitoring of diametral change without obstructing the lumen and based on the impedance measurement technique has been proposed. An in vitro comparison of wall displacement with transtubal electrical impedance change shows that the impedance changes reflect diametral changes. Another in vitro experiment in which the autorhythmicity of contractions was maintained by means of a perfusion bath indicates that the impedance changes are primarily due to the contraction of the circular muscles of the fallopian tube. These studies were followed up with long-term chronic implantations with dual probes on the isthmic and ampullar regions of the tube in female rabbits. Inpedance changes over periods as long as 6 mo could be readily obtained. Histological observations as well as fertility studies support the conclusion that the tube is minimally affected by the placement of the probes.

Animals↗