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Results for “Fallopian Tube Patency Tests”

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PubMed1994

Accuracy of endovaginal sonography for the detection of fallopian tube blockage.

The patency of 814 fallopian tubes in 414 patients was evaluated by endovaginal sonography immediately prior to hysterosalpingography. In the 659 fallopian tubes that were normal with free spillage, endovaginal sonography did not reveal any tubal or peritubal abnormality (specificity 100%). Of the 64 fallopian tubes with definite hydrosalpinx on hysterosalpingography, only 22 were detected on endovaginal sonography (sensitivity 34%). Four of 57 (7%) fallopian tubes with definite proximal blockage on the hysterosalpingogram showed hydrosalpinx on the same side on endovaginal sonography, indicating the association of proximal and distal tubal blockages in a small group of patients with blocked fallopian tubes. This combination can only be detected by the addition of endovaginal sonography to hysterosalpingography. Ten of 11 (91%) hydrosalpinges in seven patients who underwent endovaginal sonography immediately after hysterosalpingography were detected by ultrasonography. Only two of these had been visible on pre-hysterosalpingography endovaginal sonograms. This would indicate that the poor sensitivity of endovaginal sonography for diagnosing hydrosalpinx is at least partly due to its lack of distention. We conclude that an abnormal endovaginal sonogram is highly predictive of the presence of a blocked tube, but endovaginal sonography has a poor sensitivity for the diagnosis of a hydrosalpinx detectable by hysterosalpingography. Endovaginal sonography would be useful to detect a combination of proximal and distal blockage in a subgroup of patients with tubal blockage.

Adult↗
PubMed1997

Sonohysterography combined with sonosalpingography: correlation with endoscopic findings in infertility patients.

The diagnostic accuracy of sonohysterography combined with sonosalpingography or sonohysterosalpingography was evaluated in 100 infertility patients who also underwent endoscopic (hysteroscopy with or without laparoscopy) procedures. In patients with normal endometrial biopsy results, single endometrial layer thickness ranged from 3 to 5 mm and varied up to 2 mm in some areas. Diagnostic accuracy was 98% for submucosal fibroids, 96% for polyps, and 81% for synechiae. Missed lesions, were less than 2 mm in diameter. Tubal patency was successfully assessed in 79% of women with saline solution and in 92% of those who received contrast agent. This study demonstrates the efficacy of the combined use of SHG and SSG in infertility patients with uterine or tubal factor disorders.

Fallopian Tube Diseases↗
PubMed2000

Air-contrast sonohysterography as a first step assessment of tubal patency.

We assessed the use of air as a sonographic contrast agent in the investigation of tubal patency by sonohysterography. We examined 115 women assessed for infertility. After saline sonohysterography, small amounts of air were insufflated, and the tubal passage of bubbles was monitored. In five patients (excluded from the results), cervical stenosis prevented the procedure. Ninety-one tubes (right side) and 86 tubes (left side) were definitively patent; 5 and 7, respectively, were probably patent; and 12 and 16, respectively, were nonvisualized. Nine patients had polyps, 3 had synechiae, and 2 had submucosal fibroids. None of the patients had infectious complications. Air-sonohysterography and laparoscopy with chromopertubation showed agreement in 79.4%. In 17.2% of patients, the tubes were considered nonvisualized by air-sonohysterography when they were patent. The sensitivity was 85.7% and specificity 77.2%. In conclusion, air-sonohysterography is a comfortable, simple, and inexpensive first line of tubal patency investigations yielding high accuracy.

Adolescent↗
PubMed1998

[Endoscopic diagnosis of mechanic sterility].

An attempt has been made to classify mechanical tubal obliteration (proximal, distal, external obliteration). The material consisted of 798 laparoscopic procedures done in order to find the cause of female infertility. Tubal obliteration in females with secondary infertility are often associated with foci of endometriosis genitalis.

Adult↗
PubMed1999

Reproductive potential after methotrexate treatment of ectopic gestation in a community hospital.

OBJECTIVE: To compare the rates of ipsilateral tubal patency after methotrexate treatment versus conservative surgical treatment in a small community hospital lacking personnel dedicated to methotrexate management. STUDY DESIGN: From hospital and clinic records, cases of ectopic gestation within a six-year interval were identified. Method of treatment and location of the ectopic gestation were documented by review of records and confirmed by patient interviews. Women desiring fertility were offered hysterosalpingography (HSG) to evaluate tubal patency. HSG was performed under fluoroscopy with water-soluble contrast medium. RESULTS: HSG was completed in 11 cases of linear salpingostomy and 11 cases of ectopic gestations treated by methotrexate. Ipsilateral patency was documented in 8 of 11 (72%) tubes treated by linear salpingostomy and 9 of 11 (81%) methotrexate-treated tubes. One methotrexate case had a prior ipsilateral ectopic treated by salpingostomy, and two additional cases had a prior contralateral ectopic removed by salpingectomy. Each of these three cases had ipsilateral tubal patency after methotrexate for the most recent ectopic gestation. CONCLUSION: Data from this study suggest comparable tubal patency rates after methotrexate and conservative surgery. Comparable tubal patency outcomes were obtained in our community hospital despite a less-rigorous-than normal follow-up protocol.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

[Catheterization of the tubal ostium using hysteroscopy under laparoscopic guidance].

It is considered that one out of five couples present a transitory problem of infertility during their reproductive life and the most frequent cause is the tubarian pathology; from these, the proximal obstruction occupies between 25 and 30% of the cases. Unfortunatelly, the conventional method use to study tubarian patency such as histerosalpingography or the direct observation by laparoscopy and selective chromotubation, frequently do not allow to differentiate between an insufficient filling of the tubes, tubarian spasm or a true mechanical obstruction. There are certain selective tubarian cannulation techniques, for example, the catheterism with hysteroscopic guidance which is extremely usefull in the diagnosis of tubarian patency or in the confirmation of partial or total proximal tubal disease. The procedure permits to diagnosticate precisely the tubarian obstruction and also if it is due to the presence of a true pathology or simply functional, or secondary to a tubarian spasm; besides it also works as a therapeutic procedure since in the first case permits the lysis of laxe adherencies and the removal of the amorfus material that obstructs the tube and permits the catheterization. The present study determines the utility of catheterization of the tubarian ostium by hysteroscopy with laparoscopic control using the Novy (Cook, Ob/ Gyn) catheter in patients with infertility problems due to proximal obstruction of one or both of the fallopian tubes, to confirm or discard the presence of a pathological obstruction. The results are evaluated in terms of tubarian permeability and the pregnancy rate after the procedure.

Adult↗
PubMedDate not supplied

[Selective salpingography in the treatment of infertility caused by proximal tubal obstruction: apropos of 122 cases treated in Dakar].

One hundred and twenty-two women who had not conceived after more than one year of unprotected sexual relations underwent selective salpingography. All had been shown to have proximal obstruction of the fallopian tube by standard hysterosalpingography. The women underwent the procedure as outpatients during the follicular period. They were given prophylactic antibiotic treatment and salpingography was performed by a radiologist in an X-ray room. We used the commercial sets of Cook and Zorn. The mean age of patients was 34 years (range 28 to 46) and the mean duration of infertility was 7.7 years (range 2.2 to 14 years). Two hundred and forty tubes were examined, of which 213 were cleared of obstruction (88.7%), with both tubes affected in 66% of cases and only one tube affected in 33% of cases. All patients had at least one patent tube after the procedure. The patent tube was normal in 73% of cases (177 tubes) and abnormal in 15% (36 tubes). Catheterization failed in 11.3% of cases (27 tubes). Forty-nine women conceived spontaneously during the 2- to 12-month follow-up period, and 39 of these women delivered healthy babies. No extrauterine pregnancies or serious complications were reported. The most frequent side effects were slight pain, bleeding and nausea. One perforated tube was reported and none of the patients died. The greatest difficulties encountered were a lack of cooperation in patients with previous painful experiences of hysterogram and catheterization problems in women with a strongly flexed or distorted uterus. Complications were minimal and the one case of tubal perforation at the beginning of the series had no serious consequences. Thus, selective salpingography should be used more widely because it is simple and more cost-effective than the surgical management of tubal obstruction and artificial insemination. Our results suggest that this procedure should be the first-line treatment of infertility caused by proximally obstructed fallopian tubes.

Adult↗
PubMed1992

[Diagnostic value of directed anamnesis and gynecologic examination with regard to HSG investigation in diagnosis of mechanical infertility in women].

The aim of the work has been hysterosalpingographic estimation of oviductal patency in women with case histories encumbered or not encumbered by inflammations restricting the fertility, with taking into consideration the anatomical state of the reproductive organs being evaluated by gynaecological examination. Of 429 women covered by the study 102 out of a group of 277 with primary infertility reported adnexitis in their case histories, while 67 women out of a group of 152 with secondary infertility declared having had inflammations. In women, whose anamnesis included inflammations, uterine adnexa thickening as well as abdominal position of uterus with restricted movements appeared in the group of examined women with primary infertility (15.2%) about twofold, and in the group with secondary infertility (26.5%) over fourfold more frequently than in women with inflammatory--free case histories. The women, in whom the gynaecological examinations failed to reveal any changes in genital organs, regardless of the fact that they reported adnexitis, were found to have uni- or bilateral in patency of oviducts from 43.7% to 96.2%, mean in 53.74%, and in those with pubescent uteri on the average 53.75%, with thickened uterine adnexa--mean 64.46% with abdominal position and restricted movements of uterus on the average 74%. Oviductal in patency was recorded twofold more frequently in women, whose case histories disclosed uterine adnexitis.

Fallopian Tube Patency Tests↗
PubMed1992

[Evaluation of combined application of diazepam, fenoterol and metamizole in prevention of uterine-tubal spasm during the performance of hysterosalpingography].

In the years from 1989 to 1991 HSG examination was carried out in 502 infertile women. Two hours before the examination 5 mg of diazepam and 5 mg of fenoterol were orally administered, and 30 minutes prior to the procedure 2.5 mg of metamizole were given intramuscularly. The examined population of women was found to have normal patency of oviducts in 412 (82.07%) women, 48 (9.56%) had uni- or bilateral impatency of abdominal openings, in 16 (3.19%) there was uni- and in 19 (3.78%) bilateral +impatency of oviducts in uterine segments, while in 7 (1.39%) alternating impatency was disclosed. Of 502 women in 109 patients laparoscopy and chromotubation were performed during a period from 2 to 16 months after HSG examinations. In 30 (93.7%) out of 32 women with impatency of oviducts in the proximal segment, the diagnosis was confirmed. The administered drugs effectively prevent uterine-tubal spasms occurring at the time HSG is being accomplished.

Diazepam↗
PubMed1992

[Effect of hydrotubation on the anatomical state of oviducts in women with mechanical infertility].

The aim of the paper was to evaluate the anatomical state of uterine adnexa in women operated on due to mechanical infertility. Hydrotubation were previously applied in 31 women stemming from various centres in the country, while in 31 such a treatment was not performed at all. The mentioned groups of women were encumbered, to a similar degree, with a risk factor of infertility, except for the duration of sterility, which in those treated by hydrotubation lasted on the average 2 years longer. From 5 to 50 hydrotubations were carried out, most frequently in series of 5 procedures. It was reported by the women that 8 of them after hydrotubation experienced hypogastric pain persisting for some days, and in 6 there was acute adnexitis. Destructive changes in uterine adnexa, being estimated during the reconstructive operation, were decidedly more advanced in women treated by hydrotubation. That was expressed mainly by frequent appearance of lytic adhesions as well as by more advanced fibrosis of oviducts, particularly that of endosalpinx. Unchanged oviducts, after their release from adhesions, also appeared less frequently.

Acute Disease↗
PubMed1992

Radionuclide hysterosalpingography with technetium-99m-pertechnetate: application and radiation dose to the ovaries.

Although radionuclide hysterosalpingography (RNHSG) has been suggested as an efficient procedure for assessing function of fallopian tubes, the radiation dose to the ovaries was addressed as an important issue to be taken into consideration. We describe a modified method of RNHSG, calculating the radiation dose to the ovaries. A small dose of approximately 18.5 MBq (0.5 mCi) of [99mTc]pertechnetate was administered directly into the uterine cavity without overpressure. The accuracy of the method was 84.5% as compared with the contrast hysterosalpingography. The estimated average dose to the ovaries was 0.057 mGy/MBq (0.21 rad/mCi) or 1.08 mGy (108 mrad) per study. RNHSG is an accurate method for functional study of fallopian tube patency with low radiation dose.

Adult↗
PubMed1992

[Laparoscopic findings during bilateral tubal obstruction].

During the period 1987 to 1990 at Hospital Luis Castelazo Ayala, IMSS, a prospective study was carried out. For this study 374 bilateral tubal obstructions (BTO) were included in interval of gestation by means of laparoscopy with silastic rings. The objective was to observe the status presented by the organs contained in the pelvic cavity of women considered healthy; so, as to present pathology, opportunely treat it. Main findings were: Pelvic adhesions 37 cases (9.8%), uterine myomatosis 33 cases (8.8%), tubal pathology 18 cases (4.8%), ovarian cysts 11 cases (2.9%), and endometriosis 9 cases (2.4%). Global pathology was 108 cases (28.8%). The use of laparoscopy in BTO allows to find non expected pathology in apparently healthy women and offers them the opportunity of receiving treatment immediately, avoiding thus to attribute to BTO symptomatology that could be derived from existing pathology.

Adnexal Diseases↗
PubMed1992

[Uterine abnormality and fallopian tube damage--surgical correction in one session?].

From 1983 to 1990 15 metroplasties were carried out at the Department of Obstetrics and Gynecology Greifswald. 11 of these operations were combined with a microsurgical tubal operation. For the diagnostics of uterus malformation and tubal damage as many methods as possible (hysterosalpingography, laparoscopy with chromotubation, hysteroscopy and sonography) should be used. A postoperative life birth rate of 62.5% shows that an operative correction of uterus malformation and tubal damage in one session is justified. Metroplasty is also indicated at primary tubal sterility with simultaneous uterus malformation. A caesarean section is not primarily indicated after metroplasty.

Abortion, Habitual↗