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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

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

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

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

[Clinical problems, therapy and prophylaxis of primary carcinoma of the fallopian tube (author's transl)].

31 cases of primary carcinoma of the fallopian tube from 1960 to 1976 are reported. All these patients underwent operative treatment at the 1st University Clinic of obstetrics and gynaecology of Vienna. 8 out of 23 patients survived for more than 5 years. The evident advantage of a complete operation with post operative telecobalt radiotherapy for the results of 5-years-survival is shown. The possibility and necessity of prophylaxis of carcinoma of the fallopian tube by extirpation of both fallopian tubes in any case of hysterectomy are emphasized.

Adult

Studies on ciliated epithelia of the human genital tract. II. The mucociliary wave pattern of fallopian tube epithelium.

The ciliary activity of human fallopian tube epithelium was studied in vitro by using a technique which included registration of the light reflections from the mucociliary waves on the epithelial surface. In all registrations, the mucociliary waves moved toward the uterine end of the specimen. The frequencies of the reflections of the mucociliary waves ranged between 960 and 1368 cpm, with a mean of 1191 cpm (2 SD, +/- 176) and a median of 1210 cpm. Significant differences in the mucociliary wave frequencies were not observed between different parts of the fallopian tube nor between registrations performed during the follicular and luteal phases of the menstrual cycle. Scanning electron microscopy of the specimens revealed no morphologic changes of the cilia during the menstrual cycle.

Adult

Ultrasonic evaluation of fallopian tube carcinoma.

Primary malignant neoplasms of the fallopian tube are the least common of all the gynecologic malignancies, and constitute only about 0.1-1% of all such malignancies. The actual 5-year survival is 64% in those with stage I, 60% in cases of stage II, and 18% and 25% for stages III and IV, respectively. Therefore, early detection of these neoplasm stages is most important to attain a cure. The preoperative diagnosis of this neoplasm has rarely been reported because these lesions are not common. We present herein the clinical and sonographic features in 4 Japanese women with fallopian tube carcinoma. While the sonographic features alone are not distinct enough to establish a definite preoperative diagnosis, the findings as seen in our patients suggest inclusion of tubal carcinoma in the differential diagnosis.

Carcinoma

Ureteral substitute by fallopian tube. Experimental study.

Experimental substitution of a long segment of ureter by a fallopian tube was performed in dogs. Three different techniques of proximal and distal anastomosis for reconstruction of the urinary tract were used in three groups of animals. Based on this, it is believed that the fallopian tube, as a pedicle graft, could serve in female dogs as the most approximate ideal substitute for ureter because of (a) anatomic proximity to the ureter permitting blood supply to the tube, (b) the fallopian tube's mucosa lining is not affected by urinary excretions, (c) does not allow absorption of electrocytes, (d) has a muscular wall with peristaltic activity, and (e) avoids the problems of antigenicity and/or foreign body reaction.

Animals

Endocrine modulation of gamma-aminobutyric acidergic innervation in the rat fallopian tube.

The present study investigates the effect of different endocrine manipulations on the gamma-aminobutyric acid (GABA)-ergic system in the rat fallopian tube. Either hypophysectomy or ovariectomy induced a significant decrease of glutamic acid decarboxylase (GAD) activity and of GABA levels in in situ tubes. This effect was completely reversed by either gonadotropins or combined estrogen-progesterone administration, respectively. Estrogen or progesterone alone proved less effective than the administration of both steroids in counteracting the effect of ovariectomy on GAD activity. The in vitro incubation of ovariectomized rat fallopian tubes with estrogen-progesterone for 1 h failed to counteract the reduction of the GAd activity induced by surgical manipulation. The in vivo effect of estrogen-progesterone administration on the GABA-ergic system seems to be specific since steroid treatment induced the synthesis of an enzyme which was immunologically identical to the GAD present in the fallopian tube and brain of normal diestrous rat. Autotransplantation of the fallopian tube under the skin brought about a decrease of GAD activity similar to that obtained after ovariectomy. In this situation, however, estrogen-progesterone administration did not counteract the decrease of GAD activity induced by fallopian tube deafferentation. The present results demonstrate that an interaction between the GABA-ergic system and the hypothalamo-pituitary-gonadal axis seems to be operative at the level of the rat fallopian tube. However, the physiological meaning of this interrelationship between the endocrine and the peripheral nervous systems remains to be clarified.

Animals

[Fallopian tube recanalization with a catheter system--experience in the use of a balloon catheter].

Fallopian tube obstruction is one of the most difficult problems in the treatment of infertility. This report gives the results of a pilot study on the transcervical recanalization of the occlusive fallopian tube. Selective catheterization of the uterine cornu was applied through a balloon catheter, which was wedged at the internal uterine os. In 16 occlusive fallopian tubes of 11 cases, the catheterization procedure was attempted and accomplished with a 87.5% success rate. Recanalization was successful in 75.0% of the affected tubes. Subsequent pregnancy was confirmed in three cases. This convenient technique is safe and effective and it will be accepted as the first choice in the diagnosis and treatment of fallopian tube obstruction.

Adult

Carcinoma of the fallopian tube.

Primary adenocarcinoma of the fallopian tube is a rare neoplasm that constitutes less than 1% of gynecologic malignancies. Although the triad of menorrhagia, leukorrhea, and pain is said to be pathognomonic, preoperative diagnosis of this lesion is most unusual. The radiographic appearance at hysterosalpingography has only rarely been described in the English literature previously. This therefore is an unusual documentation of the preoperative appearance of fallopian adenocarcinoma by hysterosalpingography and sonography.

Adenocarcinoma

Primary adenocarcinoma of the fallopian tube.

Primary carcinoma of the Fallopian tube is one of the rarest malignancies of the female genital tract. The Authors report a case of primary carcinoma of the uterine tube and review the treatment of this disease reported in literature. Since this tumor is so rare, debatable viewpoints remain and thus new proposals and modifications of methods of staging continue to emerge. The Authors conclude by suggesting that the setting up of a National Registry for collection of data available in Italy should be organized.

Adenocarcinoma

Laparoscopic management of fallopian tube prolapse.

Sporadic cases of fallopian tube prolapse and various methods of management have been reported since the initial case described in 1902. Two cases were managed recently by a combined vaginal and laparoscopic approach. Total salpingectomy was accomplished with minimal difficulty and limited invasiveness. A brief summary of each case and detailed description of the operative technique are presented.

Adult

Diagnosis of primary adenocarcinoma of the fallopian tube.

Primary carcinoma of the fallopian tube is rare, but still occurs frequently enough to warrant consideration when certain specific symptoms are present. It is also possible to diagnose the tumor correctly if, in the presence of certain symptoms, the following diagnostic tools are used in addition to repeated Pap smears and dilatation and curettage: hysteroscopy, cervical biopsy, colposcopy, laparoscopy, laparotomy, and pathological examination of every tubal specimen.

Adenocarcinoma

Fallopian tube adenocarcinoma: common extraperitoneal recurrence.

Fallopian tube adenocarcinoma is a rare gynecologic tumor that spreads like epithelial ovarian carcinoma. From 1954 to 1982, thirty patients with tubal adenocarcinomas were treated at UCLA and by the Southern California Permanente Medical Group. The mean age was 52 years. Pain, irregular or postmenopausal bleeding, and vaginal discharge were the most common presenting symptoms. Twenty-two had undergone previous pelvic or abdominal surgery. A pelvic mass was the most common physical finding, while Pap smears, IVP, and BE were rarely helpful in making the diagnosis or planning treatment. All of the patients in this report underwent primary therapeutic surgery. Nineteen patients received radiation and fourteen, systemic chemotherapy. Surgical stage was prognostic for survival. Fourteen patients with Stage I and II disease are NED (4 at 2 years; 10 at 5 years). No patients with Stage III or IV disease survived 5 years. Recurrences were noted as late as 6 years after primary therapy and 10 of 14 recurrent sites were extraperitoneal.

Adenocarcinoma

Combination chemotherapy in advanced adenocarcinoma of the fallopian tube.

Advanced adenocarcinoma of the fallopian tube has a poor prognosis, with 5-year survival rates commonly less than 20%. Since 1980, we have managed 12 patients with disseminated tumor with combination chemotherapy following surgical cytoreduction. Analogous to the International Federation of Gynecology and Obstetrics staging of ovarian carcinoma, 3 patients were classified in Stage II, 8 in Stage III, and 1 in Stage IV. Ten patients received cisplatin-containing regimens. The 3 Stage II patients, without measurable disease after primary surgery, had an indeterminate response to chemotherapy. In Stages III-IV there were 4 complete responses (3 confirmed by second-look laparotomy) and 2 partial responses, for an overall response rate of 67%. Disease progressed in 2 patients and was stable in 1 patient. After median follow-up of 3.5 years, 4 of the Stage III-IV patients have no evidence of disease, 1 is alive with disease, and 4 are dead.

Adenocarcinoma

Expression of IgA and secretory component in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix.

The occurrence and localization of IgA and secretory components (SC) were examined in the normal and in adenocarcinomas of Fallopian tube, endometrium and endocervix. IgA-containing immunocytes were identified in the stroma of 90% of normal Fallopian tubes. It is suggested that the Fallopian tube may have an immunological function and may, together with the endocervix, constitute the local secretory immune system of the female genital tract. IgA and SC were frequently demonstrated in the cytoplasm and luminal secretion of adenocarcinomas of the endocervix, endometrium and Fallopian tube. This study has shown a decrease in immunoreactivity of SC among poorly differentiated adenocarcinomas but has failed to demonstrate any correlation between the expression of IgA and the degree of differentiation of the tumours. Secretory component appears, therefore, to be more useful than IgA as an indicator of secretory activity and differentiation of adenocarcinomas of the female genital tract.

Adenocarcinoma

Transvaginal fallopian tube catheterization in an animal model.

A rabbit model for testing the safety and effectiveness of diagnostic and interventional techniques of fallopian tube catheterization is presented. Hysterography with injection into the terminal portion of the uterine horn visualized the fallopian tube in only 6% of cases; however, this increased from 33% to 50% by pretreatment with progesterone, administration of glucagon or phentolamine, or increased pressure of injection with balloon obstruction of the uterine horn. Salpingography with a catheter introduced in the tubal ostium or directly inside the tube was most effective and resulted in a consistent (100%) visualization of the fallopian tube. The technique also allowed coaxial introduction of small diameter guidewires and catheters deep into the fallopian tube.

Animals