Transcervical falloscopic dilatation of proximal tubal occlusion. Is there an indication?
Proximal tubal occlusion (PTO), until recently a domain of microsurgery, can also be treated by a transcervical balloon dilatation and/or tubal recanalization. The aim of our study was to evaluate the possibility of transcervical tubal dilatation during transcervical Falloposcopy. Transcervical Falloposcopy and tubal dilatation was performed under laparoscopic control. During a period of 48 months a total of 157 Falloposcopies was performed. Out of a total of 157 patients, 42 patients had PTO confirmed by dye-pertubation during laparoscopy. All patients were referred because of primary or secondary tubal infertility. A total of 18 patients had bilateral PTO by dye-pertubation and of these six patients had successful bilateral and seven patients successful unilateral recanalization. The remaining five patients were unable to recanalize. A total of 24 patients had an unilateral PTO by dye-pertubation, 13 of these patients had a contralateral diseased tube, seven of which could be recanalized. Four patients had contralateral normal tubes, with successful recanalization in one patient. Seven patients had an occluded or missing contralateral tube, five of which could be recanalized. A total of 60 tubes with PTO were diagnosed, of which 32 (53.3%) tubes could be recanalized. 20 of these had normal tubes. Only patients with healthy Fallopian tubes carried pregnancies to term (five pregnancies, 12% of all patients). All patients conceived within a period of 3-6 months. We observed no ectopic pregnancy.
Schill
T
T
Department of Gynaecology and Obstetrics, Medical University of Lübeck, Germany. Schillthilo@hotmail.com
Bauer
O
O
Felberbaum
R
R
Küpker
W
W
Al-Hasani
S
S
Diedrich
K
K
D000328:Adult; D002584:Cervix Uteri; D004106:Dilatation / Q000379:methods; D005184:Fallopian Tube Diseases / Q000150:complications / Q000628:therapy*; D005187:Fallopian Tubes / Q000293:injuries; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects; D011247:Pregnancy