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.


METHODS
Prospective study approved by the hospital Institutional Review Board.


METHODS
Academic tertiary infertility center.


METHODS
Seventy-five women with hysterosalpingographic and laparoscopic evidence of endotubal disease had 112 tubes available for falloposcopic evaluation.


METHODS
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.
Kerin
J F
JF
Cedars-Sinai Medical Center, Los Angeles, California.
Williams
D B
DB
San Roman
G A
GA
Pearlstone
A C
AC
Grundfest
W S
WS
Surrey
E S
ES
D000328:Adult; D005184:Fallopian Tube Diseases / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D005186:Fallopian Tube Patency Tests / Q000379:methods; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies