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PubMedDate not supplied

Fallopian tube patency demonstrated at ultrasonography.

Fallopian tube patency was assessed in 24 infertile patients by hysterosalpingography (HSG) and ultrasonographic examination of the pouch of Douglas following transcervical injection of a sterile isotonic solution of NaCl. The presence of fluid in the pouch, after the injection, was taken to indicate tubal patency. The results of the HSG and the ultrasonographic diagnosis as to the presence of at least unilateral tubal patency were concordant in 21 patients. Pitfalls consisted of fluid accumulation in periadnexal adhesions, edema in the bowel wall, and spill of the injected saline into a large hydrosalpinx. Ultrasonography is advocated as the initial examination in assessing infertility in young women. If tubal patency is demonstrated, the patient should be recommended a six month trial period, to become pregnant, before invasive procedures are initiated.

Adolescent↗
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↗
PubMed1992

Expression of epidermal growth factor (EGF) receptor and its ligands, EGF and transforming growth factor-alpha, in human fallopian tubes.

Although human uterus is known to contain epidermal growth factor (EGF) and its receptors, it is virtually unknown whether human fallopian tubes, which are an anatomical continuation of the uterus, also contain them. Therefore, the present studies investigated whether EGF and its structural and functional homolog, i.e. transforming growth factor-alpha (TGF-alpha), and their common receptor are expressed in human fallopian tubes. Human fallopian tubes contain major 10.5-kilobase (kb) and minor 6.0-kb receptor messenger RNA (mRNA) transcripts, a single 5.0-kb EGF mRNA transcript, and a single 170-kilodalton receptor protein. The transcripts, along with their corresponding proteins and TGF-alpha protein, are present in ciliated and nonciliated epithelial cells, tubal smooth muscle, vascular smooth muscle, and endothelium. The cellular distribution and reproductive state dependency of these three regulatory molecules varied. For all of them, however, ampullary segments contained more than isthmus; proliferative phase and/or postpartum specimens contained more than secretory phase; and postmenopausal specimens contained the lowest amounts. The cell periphery and nuclear/perinuclear area of the cells contained EGF, TGF-alpha, and their receptors. Immunogold electron microscopy showed the receptors to be present in cell membranes, cilia, basal bodies which control ciliary activity, endoplasmic reticulum, nuclear membranes, and chromatin. In summary, human fallopian tubes contain EGF, EGF/TGF-alpha receptor mRNA and protein, and TGF-alpha protein. The expression of all these regulatory molecules was dependent on anatomical region, cell type, and reproductive state of the fallopian tubes. These findings suggest that EGF and TGF-alpha may regulate numerous tubal functions, thus potentially influencing fertility in women.

Blotting, Western↗
PubMed1978

Torsion of the fallopian tube.

Although an infrequent cause of acute lower abdominal pain, fallopian tube torsion should be considered whenever a woman presents with this complaint. Early diagnosis and surgical intervention may save a tube that has not yet infarcted, yet initial presentation may give little indication of the seriousness of the condition until peritonitis develops. Definitive treatment is removal of the affected adnexa. Diminished fertility and an increased incidence of ectopic pregnancy in the remaining fallopian tube follows unilateral salpingectomy. A case history of fallopian tube torsion is presented.

Abdomen, Acute↗
PubMed1990

Secretory immune system of the female reproductive tract. II. Local immune system in normal and infected fallopian tube.

The existence of a secretory immune system in the female genital tract has been demonstrated by the predominance of immunoglobulin (Ig)A-producing plasma cells in human fallopian tube, uterine cervix, and vagina. Epithelium lining fallopian tubes expresses a receptor for IgA, secretory component (SC), and thus resembles other secretory tissues such as intestine, mammary, lacrimal, and salivary glands. The present study extends the characterization of the local immune system in the fallopian tube and assesses its response to infection. We examined normal and infected fallopian tubes from surgical specimens, obtained at tubal ligation and abdominal hysterectomy, for the presence of Ig-producing cells, T cells, and natural killer cells. All tubular segments contained a predominance of IgA plasma cells in the subepithelial lamina propria. The epithelial cells were strongly positive for SC. Luminal contents stained positively for IgA, SC, and J chain, suggesting that this material contained secretory IgA. Submucosal plasma cells of IgM and IgG classes were less frequent than IgA. T cells were present in numbers approximately twofold greater than plasma cells in normal fallopian tubes. T-suppressor (CD8+) cells, which may function in the induction of immune tolerance, were present in the intraepithelial spaces. Infected segments of fallopian tubes demonstrated six- to tenfold increased numbers of plasma cells of all classes. These data suggest that a local immune system is functioning in the human fallopian tube and may provide a first line of defense against tubal infection and the prevention of tubal factor infertility.

Epithelium↗
PubMed1990

Assisted fertilization in infertile women with patent fallopian tubes. A comparison of in-vitro fertilization, gamete intra-fallopian transfer and tubal embryo stage transfer.

A comparison of the relative efficacy of in-vitro fertilization with uterine embryo transfer (IVF), tubal embryo stage transfer (TEST) and gamete intra-Fallopian transfer (GIFT) was performed in infertile patients with patent Fallopian tubes. A total of 150 couples with unexplained infertility, peritoneal endometriosis or reduced semen quality were included in the study. The three groups were comparable with regard to age distribution, indications, semen parameters, stimulation regimens, response to stimulation and numbers of oocytes retrieved. In the IVF and TEST groups there was no cleavage in 24% and a cleavage rate of only 47.6%. The highest cleavage rate was obtained in the endometriosis patients. The pregnancy rate was highest in the two groups in which in-vitro fertilization was performed, IVF = 45.7%, TEST = 37.9%, GIFT = 26.2%. To obtain one live intrauterine fetus, more oocytes had to be transferred in the GIFT group compared to the number of embryos in the IVF group, 14.4 versus 6.2, P less than 0.05. Due to a high success rate of IVF but at the same time a high frequency of no cleavage in cases of unexplained infertility or male subfertility, we recommend IVF as the primary procedure in infertile couples with patent Fallopian tubes.

Adult↗
PubMed1988

Selective transcervical fallopian tube catheterization: technique update.

A technique of transcervical fallopian tube catheterization involving use of a new vacuum hysterograph and coaxial catheter set is described. In 25 women, selective catheterization of the uterine cornua was accomplished with a 94% success rate. Ostial salpingography permitted visualization of 26% of the 46 tubes found to be obstructed or poorly visualized with conventional hysterosalpingography. Recanalization was successful in 96% of 28 proximal tubal obstructions and in 33% of six midisthmic obstructions unrelated to surgery. Recanalization attempts resulted in tubal perforations without apparent clinical effects in four tubes, one with proximal and three with midisthmic postsurgical obstructions. The new hysterograph with coaxial catheter set is more suitable for recanalization of the obstructed fallopian tubes than is the previously used balloon catheter set.

Adult↗
PubMed1987

Isolated torsion of the normal fallopian tube.

Isolated torsion of the fallopian tube is a rare disease of unknown etiology. Pathological conditions often pre-dispose to torsion. The correct diagnosis is usually not established until the operation and it is almost always necessary to remove the tube. Awareness of this condition and early laparoscopy in case of unexplained acute low abdominal pain may result in early diagnosis and possible preservation of the affected tube.

Adult↗
PubMed1989

Incidence of malignant fallopian tube tumors.

Incidence rates were examined for epithelial malignant fallopian tube neoplasms diagnosed between 1973 and 1984 and reported to nine population-based cancer registries in the United States. The average annual incidence was 3.6 per million women per year and there was no evidence of a change in the rate during the study period. Age-specific incidence followed a pattern similar to that observed for ovarian and endometrial neoplasms, rising rapidly during the reproductive years and flattening out thereafter. The incidence rate varied only slightly by race, with whites having a higher rate than blacks. Considerable variation in incidence was observed among the registries. While this could have been due to true regional differences in incidence, we cannot rule out the possibility that misclassification of fallopian tube tumors as ovarian tumors was responsible. Further investigations into the etiology of fallopian tube neoplasms should focus on the role of reproductive factors that have previously been reported as risk factors for ovarian and endometrial neoplasms.

Adult↗
PubMed1988

Prognostic features of carcinoma of the fallopian tube.

One hundred fifteen women with carcinoma of the fallopian tube were examined in this retrospective review. A third of the patients were nulliparous and 37% had evidence of old pelvic inflammatory disease. The most common symptoms were bleeding, pain, and/or vaginal discharge. Prognostic factors that predicted death from tumor were the presence of extratubal disease at initial surgery and the bulk of residual tumor left after the initial surgery. With disease limited to the fallopian tube, the depth of invasion of the tubal wall was correlated with the risk of treatment failure. Among patients with disease limited to their fallopian tubes, there was no statistically significant improvement in survival with the addition of either pelvic irradiation or single-agent chemotherapy. Among women with extrapelvic disease, survival improved significantly with the use of cis-platinum-containing multiagent chemotherapy.

Adult↗
PubMed1989

Primary adenocarcinoma of the fallopian tube--a case report.

Adenocarcinoma of the fallopian tube is a rare clinical entity. The incidence of primary tubal carcinoma has been reported as varying from 0.1 to 1.0 percent of all gynaecological malignancies. In Malaysia the incidence is unknown. A case of primary adenocarcinoma of the fallopian tube is reported.

Adenocarcinoma↗
PubMed1977

The role of prostaglandins in the spontaneous motility of the fallopian tube.

Spontaneous isometric contractions of the human fallopian tube were measured in vitro. The tubes were obtained during the follicular phase of the menstrual cycle in 16 experiments and during the luteal phase in 23 experiments. The area under the curve and the frequency of spontaneous isometric contractions, together with the amount of prostaglandins E and F produced by the tube, were measured. Using each tissue as its own control, the effects of adding indomethacin or papeverine to the tissue both were assessed. Indomethacin, a prostaglandin synthetase inhibitor, significantly reduced the prostaglandin output without affecting the tubal motility. By contrast, papaverine, which is a smooth muscle relaxant but not an inhibitor of prostaglandin synthesis, significantly reduced both motility and prostaglandin output. It is concluded that prostaglandins do not have a direct role in the regulation of the spontaneous motility of the human fallopian tube.

Fallopian Tubes↗
PubMed1985

Absorbable external rings for anastomosis of the fallopian tubes: a feasibility study.

A novel approach to tubotubal anastomosis with external, absorbable, ring-shaped devices was evaluated. Fallopian tubes of female Sprague-Dawley rats were transected and coagulated and either left divided or anastomosed with microsurgical technique, with or without external rings. Postoperative patency and pregnancy rates were used to evaluate the procedures. Transected and coagulated fallopian tubes remained occluded at the time of repeated surgery, and no implantations were observed in the corresponding uterine horns. Of ten fallopian tubes anastomosed without the ring, five were patent and five were partially blocked. All ten fallopian tubes anastomosed with the external rings were fully open. Implantation sites were observed in four of ten uterine horns corresponding to fallopian tubes anastomosed without the ring and in eight of ten horns anastomosed with the external ring. The difference was statistically significant, P = to 0.03. All external rings were completely absorbed 7 weeks after anastomosis. The new technique was simpler to perform and was less time-consuming. We conclude that tubotubal anastomosis with external rings may offer advantages over the conventional technique.

Animals↗
PubMed1976

Ectopic pancreas in the fallopian tube. Report of a first case.

A case of ectopic pancreas in the fallopian tube is reported. This small, polypoid, benign tumor was in a fallopian tube contralateral to a ruptured tubal pregnancy. The patient had a tubal ligation performed six years previously. To the best of our knowledge this is the first reported case of isolated ectopic pancreas in a fallopian tube. No explanation is offered for the pathogenesis of this lesion.

Adult↗
PubMed1990

Histopathology of fallopian tubes with recurrent tubal pregnancy.

Fifteen fallopian tubes in which a previous ipsilateral eccyesis was managed by conservative surgical techniques were examined. The condition of the tube relative to the previous surgical management and the resolution of the previous implantation sites were correlated with the recurrent tubal pregnancy. All previous incisions were identified and all were well-healed, except for one fistula. Residual histologic evidence was present in only five of 16 previous implantation sites. The recurrent eccyeses were related to previous surgical management in only three women, two after anastomosis and one because of inadvertent obstruction of the tube. The cases of tubal obstruction and tuboperitoneal fistula formation were thought to reflect a lack of understanding of the pathologic changes associated with tubal pregnancy during conservative surgery. The previous tubal incision sites were all remarkably well-healed regardless of whether they were primarily closed or left open, and independent of location. Infundibular or fimbrial "milk-outs" were without histologic evidence of damage. The underlying tubal disease (chronic salpingitis, follicular salpingitis, or salpingitis isthmica nodosa) seems to be the major factor identified that is associated with, and probably the cause for, the recurrent tubal gestation.

Adult↗