Abstract
Proximal tubal blockage is most commonly caused by an inflammatory process such as salpingitis isthmica nodosa, endometriosis, and surgical trauma such as post-myomectomy. Tubal disease is one of the most common diagnoses for IVF and upon diagnosis, IVF is most often recommended. However, many women decide not to proceed with IVF due to the cost, or religious reasons. Fallopian tube cannulation either with hysteroscopy/laparoscopy or under fluoroscopy at the time of HSG can be performed with patency rates of 70–80 percent but the pregnancy rates remain low. This chapter reviews the causes of proximal tubal blockage, diagnosis, treatment, and success rates.
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References
Wallach EE, Musich JR, Behrman SJ. Surgical management of tubal obstruction at the uterotubal junction. Fertil Steril. 1983;40(4):423–41.
Das S, Nardo LG, Seif MW. Proximal tubal disease: the place for tubal cannulation. Reprod Biomed Online. 2007;15(4):383–8.
Eddy CA. Tubal physiology and microsurgery. Aust N Z J Obstet Gynaecol. 1981;21(3):129–33.
Sweeney WJ. The interstitial portion of the uterine tube—its gross anatomy, course, and length. Obstet Gynecol. 1962;19(1):3–8.
Avner Hershlag MPD, DeCherney AH. Tubal physiology: an appraisal. J Gynecol Surg. 1989;5(1):3–25.
L V. The intramural part of the fallopian tube. Int J Fertil. 1959;4:309–14.
F.E. L. Upper genital tract infections in women. In: Nelson ALWJ, Wysocki S, editors. Sexually transmitted diseases current clinical practice. Totowa, NJ: Humana Press; 2006. p. 183–203.
Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol. 1975;121(5):707–13.
Jenkins CS, Williams SR, Schmidt GE. Salpingitis isthmica nodosa: a review of the literature, discussion of clinical significance, and consideration of patient management. Fertil Steril. 1993;60(4):599–607.
Sasson IE, Taylor HS. Stem cells and the pathogenesis of endometriosis. Ann N Y Acad Sci. 2008;1127:106–15.
Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–99.
Qi H, Zhang H, Zhang D, Li J, Huang Z, Zhao X, et al. Reassessment of prevalence of tubal endometriosis, and its associated clinicopathologic features and risk factors in premenopausal women received salpingectomy. Eur J Obstet Gynecol Reprod Biol X. 2019;4:100074.
Kerin JF, Surrey ES, Williams DB, Daykhovsky L, Grundfest WS. Falloposcopic observations of endotubal isthmic plugs as a cause of reversible obstruction and their histological characterization. J Laparoendosc Surg. 1991;1(2):103–10.
Dessole S, Meloni GB, Capobianco G, Manzoni MA, Ambrosini G, Canalis GC. A second hysterosalpingography reduces the use of selective technique for treatment of a proximal tubal obstruction. Fertil Steril. 2000;73(5):1037–9.
Simpson WL Jr, Beitia LG, Mester J. Hysterosalpingography: a reemerging study. Radiographics. 2006;26(2):419–31.
Papaioannou S. A hypothesis for the pathogenesis and natural history of proximal tubal blockage. Hum Reprod. 2004;19(3):481–5.
Swart P, Mol BW, van der Veen F, van Beurden M, Redekop WK, Bossuyt PM. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995;64(3):486–91.
Thurmond AS, Novy M, Rösch J. Terbutaline in diagnosis of interstitial fallopian tube obstruction. Investig Radiol. 1988;23(3):209–10.
Hurd WW, Wyckoff ET, Reynolds DB, Amesse LS, Gruber JS, Horowitz GM. Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography. Obstet Gynecol. 2003;101(6):1275–8.
Honoré GM, Holden AE, Schenken RS. Pathophysiology and management of proximal tubal blockage. Fertil Steril. 1999;71(5):785–95.
Holz K, Becker R, Schürmann R. Ultrasound in the investigation of tubal patency. A meta-analysis of three comparative studies of Echovist-200 including 1007 women. Zentralbl Gynakol. 1997;119(8):366–73.
Schlief R, Deichert U. Hysterosalpingo-contrast sonography of the uterus and fallopian tubes: results of a clinical trial of a new contrast medium in 120 patients. Radiology. 1991;178(1):213–5.
Bij de Vaate AJ, Brölmann HA, van der Slikke JW, Emanuel MH, Huirne JA. Gel instillation sonohysterography (GIS) and saline contrast sonohysterography (SCSH): comparison of two diagnostic techniques. Ultrasound Obstet Gynecol. 2010;35(4):486–9.
Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med. 2000;19(8):519–27.
Grant A. Infertility surgery of the oviduct**presented at the eighteenth annual meeting of the Pacific Coast Fertility Society Phoenix, Arizona, 1970. Fertil Steril. 1971;22(8):496–503.
Fayez JA. Comparison between tubouterine implantation and tubouterine anastomosis for repair of cornual occlusion. Microsurgery. 1987;8(2):78–82.
Gomel V. Tubal reanastomosis by microsurgery. Fertil Steril. 1977;28(1):59–65.
Winston RM. Microsurgical tubocornual anastomosis for reversal of sterilisation. Lancet. 1977;1(8006):284–5.
Practice Committee of the American Society for Reproductive Medicine. Role of tubal surgery in the era of assisted reproductive technology: a committee opinion. Fertil Steril. 2021;115(5):1143–50.
Ellis H. The cause and prevention of postoperative intraperitoneal adhesions. Surg Gynecol Obstet. 1971;133(3):497–511.
Thurmond AS. Pregnancies after selective salpingography and tubal recanalization. Radiology. 1994;190(1):11–3.
Novy MJ, Thurmond AS, Patton P, Uchida BT, Rosch J. Diagnosis of cornual obstruction by transcervical fallopian tube cannulation. Fertil Steril. 1988;50(3):434–40.
Hou HY, Chen YQ, Li TC, Hu CX, Chen X, Yang ZH. Outcome of laparoscopy-guided hysteroscopic tubal catheterization for infertility due to proximal tubal obstruction. J Minim Invasive Gynecol. 2014;21(2):272–8.
De Silva PM, Chu JJ, Gallos ID, Vidyasagar AT, Robinson L, Coomarasamy A. Fallopian tube catheterization in the treatment of proximal tubal obstruction: a systematic review and meta-analysis. Hum Reprod. 2017;32(4):836–52.
Gomel V. The place of reconstructive tubal surgery in the era of assisted reproductive techniques. Reprod Biomed Online. 2015;31(6):722–31.
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Liu, X., Akhavan, S., Stadtmauer, L. (2022). Proximal Tubal Obstruction. In: Lindheim, S.R., Petrozza, J.C. (eds) Reproductive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-05240-8_7
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DOI: https://doi.org/10.1007/978-3-031-05240-8_7
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