Histology of proximal tubal obstruction in cases of unsuccessful tubal canalization.
OBJECTIVE
To determine possible etiologies of unsuccessful fluoroscopically guided tubal canalization, we studied the histology of tubal segments in cases of failed canalization for proximal tubal obstruction. Factors contributing to cases of unsuccessful fluoroscopically guided tubal canalization remain unclear.


METHODS
Prospective.


METHODS
Reproductive Endocrinology Clinic.


METHODS
Twenty-seven cornual and/or isthmic tubal segments from 15 patients who underwent proximal tubal surgery after fluoroscopically guided tubal canalization were studied. Specimens were prepared with hemotoxylin-eosin and Masson trichrome stains.


RESULTS
Histologic examination of excised cornual and isthmic tubal segments revealed abnormalities in 93% of specimens. Obliterative fibrosis (61%), chronic salpingitis (57%), and salpingitis isthmica nodosa (42%) were the most commonly found histologic tubal abnormalities. One case of complete tubal occlusion and tubal schistosomiasis was also detected.


CONCLUSIONS
These data suggest that cases of failed fluoroscopically guided tubal canalization may be secondary to severe intrinsic tubal disease and tubal occlusion and not to the technique. Fluoroscopically guided tubal canalization may provide a means of differentiating a functional obstruction amenable to conservative management from true occlusion requiring management by microsurgical techniques or in vitro fertilization.
Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii.
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Letterie
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Sakas
D000328:Adult; D000714:Anastomosis, Surgical; D002404:Catheterization; D003251:Constriction, Pathologic / Q000473:pathology / Q000601:surgery / Q000628:therapy; D005184:Fallopian Tube Diseases / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008866:Microsurgery; D012086:Reoperation