[Analysis of 1006 cases with selective salpingography and fallopian tube recanalization]

To retrospectively analysis of selective salpingography (SSG) and fallopian tube recanalization (FTR) in 1006 infertile women with tube obstruction, to summarize their clinical effect and practical value, to analyze the related factors which can improve treatment effect and pregnancy rate, and give suggestions of their indication and contraindication.

SSG and FTR using self-made coaxial catheter were carried out in 1006 infertile cases with tube obstruction of various portions and extents confirmed by hysterosalpingography (HSG). The one-year cumulative pregnancy rate and the effective rate by HSG reexamination were calculated, in combination with dynamic observation of preoperative HSG and intraoperative tube imaging.

In the complete tubal occlusion group of 601 tubes in 315 cases, the recanalization rate was 87.9% (528/601), among which, 35.4% was only treated by SSG and 64.6% by FTR. Postoperative pregnancy rate and ectopic pregnancy rate were 39.9% and 2.7% respectively, and tubal reocclusion was 1.8% in one-year's follow up. In those failure to recanalization, tubal tuberculosis was in 4 cases, salpingitis isthmica nodosum was in 3 cases, isthmic occlusion was in 9 cases with club-changed terminal, ampullar or fimbrial occlusion was in 6 cases, and tubal fibrosis in 10 cases. In the incomplete tubal occlusion group of 1314 tubes in 691 cases, catheterized hydrotubation was carried out. Fimbrial adhesion diagnosed by HSG was found false positive or negative in 65 cases. The pregnancy rate was 53.6%, 45.7% and 26.8% in the mildly, moderately and severely occluded cases respectively. The ectopic pregnancy rate was 1.4%. The patent rate confirmed by HSG reexamination was 86.9% one year later. Sixteen cases with obvious fimbrial adhesion or enwrapped adnexa in both groups were treated by laparoscopy, with a coincidence rate of 97.1%.

Selective salpingography and fallopian tube recanalization have both effects of diagnosis and treatment on tubal infertility. The techniques are simple, safe, and credible, and worth to be applied clinically. Knowing the shapes of fallopian tube confirmed by preoperative HSG can increase the rates of recanalization.