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Research Paper | Medicine | India | Volume 12 Issue 6, June 2023 | Popularity: 5.9 / 10

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Treatment of Proximal Tubal Occlusion by Transcervical Fluoroscopic Guide Wire Mediated Fallopian Tube Recanalization in Female Infertility

Dr. Rujuta Fuke, Dr. Rekha Sapkal, Dr. Rashmi Kahar

Abstract: Introduction: As tubal factors comprise 25 to 30% cases of infertility and proximal tubal occlusion is associated with 30 - 35% of cases of tubal disease, the assessment of patency of fallopian tubes is an essential part of any infertility work up. Transcervical fluoroscopic guide wire mediated catheterization provides an access that makes cornual or proximal fallopian tube obstruction amenable to selective recanalization. In fallopian tube recanalization, a catheter and guide wire system are used to clear proximal fallopian tube obstructions. The aim of the study was to evaluate the role of transcervical guide - wire mediated fallopian tube recanalization in the treatment of proximal fallopian tube occlusion. Observations and Results: Total 60 subjects showed either unilateral or bilateral block on HSG. Bilateral block was more common than unilateral block. Total number of tubes showing blockage were 106. Prevalence of tubal blockage responsible for infertility was seen in 20% of study population. Prevalence of proximal tubal obstruction in infertile population under study was 15.33%. Prevalence of distal tubal occlusion in infertile population in this study was 5.66%. Tubal recanalization procedural rate was successful in 94.82%. Only tubes showing cornual block were subjected to catheterization. Four patients complained of mild discomfort or cramp like pain and 3 patients had spotting. Follow - up after 3 months for tubal patency showed re - occlusion in 4 patients whereas major complications like perforation or flare up of infection and allergic reaction to HSG contrast were not observed in this study. Conclusion: In the present study, transcervical guide wire mediated fallopian tube recanalization was successful in 94.82% of tubes. The procedure is advocated to diagnose precise site or sites of obstruction and to recanalize proximal obstructions of the tube. It does not affect the outcome of other treatment modalities such as GIFT, microsurgery or in vitro fertilization. Thus, it is an easy, non - surgical, comparatively non - invasive alternative to the standard treatment of surgical correction by hysteroscopy or resection anastomosis.

Keywords: Hysterosalpingography, HSG, Fallopian Tube Recanalization, FTR, Selective salpingography, HSS, Proximal tubal occlusion, Female infertility

Edition: Volume 12 Issue 6, June 2023

Pages: 735 - 740

DOI: https://www.doi.org/10.21275/SR23604172538

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