Hysteroscopic cannulation for proximal tubal obstruction: a change for the better?

Kamalini Das, Theodore C. Nagel, John W. Malo
In: Fertility and Sterility · 1995 · vol. 63(5) , pp. 1009–1015 · doi:10.1016/s0015-0282(16)57539-6 · PMID:7720909 · W148738720
article OA: closed CC0 ⤵ 2 in-corpus citations
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This study investigated hysteroscopic cannulation as a treatment for proximal tubal obstruction to assess its efficacy and impact on patient outcomes.

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Abstract

ObjectiveTo compare overall the results of hysteroscopic tubal cannulations and resection anastomosis for proximal tubal occlusion.DesignNonrandomized retrospective analysis of patients operated on by two surgeons.SettingUniversity and large tertiary referral private practice.PatientsSeventy-four patients over a 10-year period, with bilateral or unilateral proximal occlusion of a single tube.InterventionsHysteroscopic cannulation, resection anastomosis, or both.Main outcome measuresIntrauterine and ectopic pregnancy rates, long-term tubal patency, and pathology of tubal segments.ResultsIn patients with normal distal tubes, intrauterine pregnancy rates were similar (12/21, 57% versus 12/24, 50%) and ectopic pregnancy rates were lower (0/21, 0% versus 7/24, 29.1%) in the cannulation group. One-year patency rates in nonpregnant patients was higher in the anastomosis group (12/15, 80% versus 3/8, 33%).ConclusionsHysteroscopic cannulation should be first choice in the management of proximal tubal obstructions in selected patients. It may be a treatment option for delayed occlusion after successful cannulation or resection anastomosis.

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