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Published on: January 22, 2022
Selective salpingography and fallopian tube catheterisation by guidewire
1Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, Leicester, UK. vineetalka@aol.com
Summary
Selective salpingography and tubal cannulation (SS/TC) offers a viable treatment for proximal tubal obstruction, achieving high patency rates and successful pregnancies. This fertility procedure should be considered before in vitro fertilization (IVF) or surgery.
Area of Science:
- Reproductive medicine
- Gynecological surgery
- Minimally invasive gynecological procedures
Background:
- Proximal tubal obstruction is a significant cause of female infertility.
- Management options for tubal obstruction include in vitro fertilization (IVF), tubal surgery, and selective salpingography and tubal cannulation (SS/TC).
- The National Institute of Clinical Excellence (NICE) recommends SS/TC, but its adoption in the UK is variable.
Purpose of the Study:
- To evaluate the efficacy and outcomes of selective salpingography and tubal cannulation (SS/TC) in patients with proximal tubal obstruction.
- To assess the rates of tubal patency, pregnancy, and ectopic pregnancy following SS/TC.
- To determine the role of SS/TC as a therapeutic option for infertility due to proximal tubal block.
Main Methods:
- Retrospective review of patients who underwent selective salpingography and fallopian tube catheterisation (SS/TC).
- Analysis of procedural success in achieving tubal patency.
- Tracking of pregnancy outcomes, including intrauterine and ectopic pregnancies.
- Correlation of SS/TC outcomes with pre-existing laparoscopy findings.
Main Results:
- SS/TC was performed on 16 patients.
- Tubal patency was achieved in 16 out of 20 attempted tubes (80%).
- Pregnancy occurred in 35% of patients post-procedure, with an ectopic pregnancy rate of 7%.
- One successful pregnancy resulted from a repeat SS/TC procedure.
- Laparoscopy findings were valuable in predicting procedure success and ectopic pregnancy risk.
Conclusions:
- Selective salpingography and tubal cannulation (SS/TC) is an effective treatment for proximal tubal obstruction, leading to successful pregnancies.
- The procedure demonstrates high rates of tubal patency and a manageable risk of ectopic pregnancy.
- SS/TC should be considered a primary therapeutic option for proximal tubal blockage before pursuing more invasive treatments like IVF or tubal surgery.
