title: Hysteroscopic cannulation for proximal tubal obstruction: a change for the better?
abstract: OBJECTIVE
  To compare overall the results of hysteroscopic tubal cannulations and resection anastomosis for proximal tubal occlusion.
  
  
  METHODS
  Nonrandomized retrospective analysis of patients operated on by two surgeons.
  
  
  METHODS
  University and large tertiary referral private practice.
  
  
  METHODS
  Seventy-four patients over a 10-year period, with bilateral or unilateral proximal occlusion of a single tube.
  
  
  METHODS
  Hysteroscopic cannulation, resection anastomosis, or both.
  
  
  METHODS
  Intrauterine and ectopic pregnancy rates, long-term tubal patency, and pathology of tubal segments.
  
  
  RESULTS
  In 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%).
  
  
  CONCLUSIONS
  Hysteroscopic 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.
authors.affiliation: Reproductive Health Associates, St. Paul, Minnesota, USA.
authors.forename: K
authors.initials: K
authors.lastname: Das
authors.forename: T C
authors.initials: TC
authors.lastname: Nagel
authors.forename: J W
authors.initials: JW
authors.lastname: Malo
mesh_terms: D000714:Anastomosis, Surgical; D002404:Catheterization; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005186:Fallopian Tube Patency Tests; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic; D012189:Retrospective Studies