The efficacy of transcervical recanalization of obstructed postoperative fallopian tubes.
The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes was evaluated in 29 patients who were referred for recanalization. Nineteen had strictures at the site of Fallopian tube reconstruction, and five had strictures, three had fistulae, and two had fistulae and strictures at the site of reversal surgery. A 0.014-inch highly flexible guidewire was passed through the obstruction into the ampullary segment, followed by a 1. 1-2.2 Fr bougie catheter to dilate the stricture. After recanalization, the distal tube was studied by selective salpingography. The method was technically successful in 17 of 19 patients with underlying inflammatory disease and resultant postoperative strictures. The tubes remained patent in 12 patients for a period of 12-48 months; three patients conceived, all delivering healthy babies. Significant disease of the distal tubes was present in seven patients. The technique succeeded in three of five patients with postoperative strictures following reversal surgery. One patient subsequently conceived and delivered a healthy baby. The technique failed in all five patients with fistulae complicating reversal surgery. Transcervical recanalization is thus recommended in the management of patients with postoperative strictures with underlying inflammatory obstruction and strictures complicating reversal surgery.
Lang
E K
EK
Department of Radiology, LSU School of Medicine, New Orleans, LA 70112, USA.
D000328:Adult; D002404:Catheterization / Q000295:instrumentation; D002584:Cervix Uteri; D003251:Constriction, Pathologic / Q000628:therapy; D036861:Delivery, Obstetric; D005069:Evaluation Studies as Topic; D005184:Fallopian Tube Diseases / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005306:Fertilization; D005402:Fistula / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography; D008866:Microsurgery / Q000009:adverse effects; D011183:Postoperative Complications; D011247:Pregnancy; D012488:Salpingitis / Q000601:surgery / Q000628:therapy; D013243:Sterilization Reversal / Q000009:adverse effects; D013246:Sterilization, Tubal; D016896:Treatment Outcome