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Results for “Fallopian Tube Diseases”

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At least 19 recordsLinked to original sources
PubMed1994

Fallopian tube disease: limited value of treatment with fallopian tube catheterization.

PURPOSE: Therapeutic role of fallopian tube catheterization was prospectively studied in patients with bilateral fallopian tube obstruction. MATERIALS AND METHODS: Catheterization was performed in 42 patients with bilateral obstruction; 36 of the patients (67 fallopian tubes) underwent recanalization. RESULTS: Fifty-two tubes with 54 proximal obstructions were successfully recanalized (technical success rate, 96%), 36 with selective catheterization and 16 with coaxial techniques. Among 13 tubes blocked at the distal portion of the tube, six tubes were negotiated. Perforation or subintimal injury occurred in three tubes, and one patient eventually had a tubal pregnancy. During follow-up of 3 months to 4 years, five patients had conceived, including the patient with a tubal pregnancy and one patient who experienced spontaneous abortion during the first trimester. CONCLUSION: Fallopian tube catheterization is technically highly successful and diagnostically useful. However, its role in treating fallopian tube diseases is limited, and patients with distally blocked tubes are not good candidates for this procedure.

Adult↗
PubMed2000

Fallopian tube disease: the cobblestone pattern as a radiographic sign.

PURPOSE: To identify radiographic signs of mucosal damage by comparing hysterosalpingography with salpingoscopy in a prospective study. MATERIALS AND METHODS: Forty-one candidates for laparoscopy underwent hysterosalpingography and peroperative salpingoscopy; at both, tubal patency was noted. Radiographic criteria for mucosal abnormality were rounded filling defects (ie, the cobblestone pattern) and the absence of longitudinal radiolucent bands in the ampullary tract. At salpingoscopy, tubal mucosa was categorized by means of inspection into five classes of fold pattern: classes I and II, normal; classes III-V, abnormal. Hysterosalpingographic and salpingoscopic results were compared by means of a two-by-two table and kappa statistics. RESULTS: Seventy-four tubes were evaluated. At hysterosalpingography, 31 tubes were distally nonpatent. Of these, 26 showed a distal obstruction at salpingoscopy. None of the patent tubes at hysterosalpingography showed obstruction at salpingoscopy. The agreement between hysterosalpingography and salpingoscopy in detecting abnormal mucosal pattern was 89.2% (kappa, 0.73; P: <.001). The cobblestone pattern always corresponded to intraluminal adhesions at salpingoscopy. The absence of radiolucent bands corresponded to abnormal mucosa at salpingoscopy in four of six cases. The cobblestone pattern was found only in hydrosalpinges and never in patent tubes. Six normal patent tubes at hysterosalpingography showed intraluminal adhesions at salpingoscopy. CONCLUSION: Results indicate that the cobblestone pattern is an effective radiographic sign of intraluminal adhesions in hydrosalpinges and suggest that intraluminal disease in patent tubes might not always be excluded on normal hysterosalpingograms.

Adult↗
PubMed1992

Outpatient falloposcopy: intra-luminal imaging of the fallopian tube by trans-uterine fibre-optic endoscopy as an outpatient procedure.

OBJECTIVE: To develop trans-uterine falloposcopy using the linear eversion technique in outpatients. DESIGN: A prospective, descriptive study of the introduction and application of this new technique. SETTING: A tertiary referral University Research Clinic independent of operating theatres and inpatient admission. SUBJECTS: Twenty-one infertile women with previous evidence of fallopian tube disease. MAIN OUTCOME MEASURES: Rate of successful tubal cannulation and procedure completion, tubal section visualized, condition of the tubal epithelium, subsequent treatment plan. RESULTS: A bilateral examination was attempted in 19/21 patients and completed in 18. Two early falloposcopies with inadequate analgesia were aborted due to pain after only one tube had been examined without an attempt to identify or cannulate the contralateral tubal ostium. In one patient, neither ostium was identified or cannulated. After ostial localization, 37/37 tubes were cannulated. If the ostium was not localized but 'blind' cannulation attempted, 1/3 were cannulated successfully. Epithelium characteristic of the ampulla was seen in 31/38 (82%) tubes, and of the proximal tube only in 3/38 (8%). Successful bilateral assessment noted complete bilateral proximal obstruction in 2/18 patients, non-obstructive bilateral endotubal damage in 7/18, unilateral damage in 3/18 and bilateral healthy tubes in 6/18. Unilateral examination in two patients found minimal evidence of damage in one and severe intra-tubal adhesions in the other. After falloposcopy, 11/21 patients elected for IVF, 9/21 tubal surgery and 1/21 for IVF whilst awaiting surgery. CONCLUSION: Falloposcopy is a technique which can be performed in an outpatient clinic. It is well tolerated, and high rates of luminal cannulation and visualization are possible. Atraumatic access to the tube and visualization of its lumen offer exciting opportunities for diagnosis and treatment of tubal conditions.

Ambulatory Care↗
PubMed1997

Hydrosalpingeal fluid inhibits in-vitro embryonic development in a murine model.

Recent evidence describing a suboptimal clinical outcome in women with hydrosalpinges who undergo in-vitro fertilization (IVF) and embryo transfer suggests a potential deleterious effect of this fluid on in-utero embryo development. Consequently, we evaluated in-vitro mouse embryo development in the presence of hydrosalpingeal fluid (HF) collected from 10 infertile women of reproductive age. Chemical analyses showed both similarities and differences of these fluids to reported values for fluids collected from non-diseased Fallopian tubes. The HF had a significant deleterious effect upon mouse embryo cleavage and development to the expanded and hatched blastocyst stage, although the effect was variable among patients. Dilution of HF to 30% concentration with culture medium failed to negate this effect. This argues against the effect resulting from a relative lack of critical, supportive component(s) in the HF. Additionally, further experiments performed with cultures under an oil overlay significantly reduced the embryotoxicity of the HF. This evidence suggests there may be a lipophilic factor that can impair embryo development. The relatively poor IVF-embryo transfer success in women with proximally patent hydrosalpinges may be explained, at least in part, by reflux of a lipophilic embryotoxic factor(s) into the uterine cavity.

Animals↗
PubMed1992

Falloposcopic classification and treatment of fallopian tube lumen disease.

OBJECTIVE: To devise a diagnostic classification and scoring system for tubal lumen disease based on falloposcopy and to evaluate it against tuboplasty procedures and pregnancy outcomes. DESIGN: Prospective study approved by the hospital Institutional Review Board. SETTING: Academic tertiary infertility center. PATIENTS: Seventy-five women with hysterosalpingographic and laparoscopic evidence of endotubal disease had 112 tubes available for falloposcopic evaluation. INTERVENTION: Diagnostic and operative falloposcopy was performed, when indicated, using aquadissection, flexible wire cannulation, or direct balloon tuboplasty. RESULTS: The endotubal lumens were considered to be falloposcopically normal in 52 tubes (46%), to contain mild to moderate disease in 33 (29%), and severe to obstructive disease in 27 (25%) cases. Within a year of the procedure, 6 of the 28 women (21%) in whom at least 1 tube was normal conceived, in 2 of 22 (9%) with mild to moderate disease, and in 0 of 16 (0%) with severe endotubal disease. CONCLUSIONS: Falloposcopy provides a visual means of scoring endotubal disease and may be intrinsically therapeutic for dislodging intraluminal debris and breaking down filmy adhesions in normal or minimally diseased tubes. The presence of severe disease remains resistant to the use of current endotuboplasty treatments as reflected by poor pregnancy outcome, and such women should be provided the option of microsurgical tubal repair or in vitro fertilization and embryo transfer procedures.

Adult↗
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↗
PubMed1993

[Chlamydia trachomatis, pelvic inflammatory diseases and sterility].

The authors analyse the results of direct (cervical, urethral, tubal) and serological research of Chlamydia trachomatis in a sample population of 420 women undergoing celioscopy due to sterility and pelvic pain, paying particular attention to a group of 193 who were found to be suffering from PID (acute, sequelae). In terms of absolute numbers the correlation between chlamydial contact-PID-sterility is confirmed, whereas in an analysis of the levels of direct positivity it is only significant for acute PID, and in cases of sequelae and in sterility with chronic infection with or without tubal damage the direct identification of Chlamydia trachomatis does not differ much from controls. Salpingo-peritoneal isolation was found to be completely lacking in significance.

Acute Disease↗