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Selective fallopian tube imaging and treatment of fallopian tube recanalization of 40 cases of obstructive infertility

Infertility factors, l / 2 [3]. The cramps, abdominal adhesions, mucous congestion and other reasons, conventional hysterosalpingography have limitations, due to lipiodol for the fat-soluble, insoluble in water,[link widoczny dla zalogowanych], viscosity, diffusion is slow, difficult through the narrow lumen, often causing images diagnosis of false positive results, false positive rate as high as 30% 【4】, particularly more blockage of interstitial insufficient Lipiodol angiography to determine patency for a long time, about 24h, significant abdominal pain in some patients, iodized oil slowly absorbed in the body , a longer lifetime, can cause chronic inflammatory granuloma, such as counter-current of human venous thrombosis can lead to complications such as blood vessels. And 60% diatrizoate for the water-soluble contrast agents, mobility, and diffuse strong, easy to distort the fallopian tube through the narrow cavity, showing fine structure, it will not upstream into the formation of vascular emboli, but in the majority after 30min excreted by the kidneys. The fallopian tube tissue fragments cavity, mucus plugs, and other factors have led to tubal spasm proximal tubal obstruction is reversible _5J, this time with a catheter guide wire through the narrow or even block the site, often make the fallopian tube recanalization. The tubal obstruction infertility treatment intervention, as a new tubal recanalization surgery,[link widoczny dla zalogowanych], has the double meaning of the diagnosis and treatment. X-ray of the operations carried out under the TV monitor to avoid recanalization blindness during the same time, directly in the fallopian tubes in order to consolidate the curative effect of drug infusion, angiography showed no false positive, and does not require hospitalization and surgery, the patient pain, whole course of treatment no more than half an hour to complete in the clinic. Our data shows tubal recanalization rate of 82.9%, after 6 to 12 months of pregnancy rate of 35.0%, in line with domestic reports _6J. If the operation fails, after lining repair, redo after the next menstruation, the early re-occlusion of the treatments can be repeated, especially after abdominal surgery for proximal obstruction can not be solved, the failure will not affect the use of peritoneal cancer recurrence mirrors or open surgery, but should be strictly controlled tubal recanalization of the indications and contraindications. If severe heart and lung failure, iodine allergy, acute genital inflammation,[link widoczny dla zalogowanych], fever,[link widoczny dla zalogowanych], menstrual period, a coagulopathy should be banned in line salpingography, in addition to also to be regarded as indications; but for tubal umbrella side and accompanied by severe adhesion who was water, poor efficacy of intervention, feasible laparoscopic surgery and tubal adhesiolysis colostomy. Distal tubal ampulla, the umbrella should not be line-side occlusion recanalization, because of tubal tortuous, soft, fixed degree, through the guide wire is not easy, plus there muscle weakness, tubal perforation rate of up to 3% to 11%. While the fallopian tube perforation of the injury is extremely small and can be self-healing, but the inflammation caused by the easily lead to tubal damage and tubal mucosa adhesion, increase the tube tubal infertility [7l. Local severe obstruction of uterine, tubal ligation anastomosis recanalization and recurrence after obstruction diagnosed as tuberculous tubal occlusion not oviduct intervention, such as tubal disease to poor compliance, easily perforated. Our data show that interstitial tubal recanalization with isthmus block rate was 93.1%, with the umbrella Department of ampullary obstruction recanalization rate was 33.3%. Uterine horn or the uterus can be seen near the corner of the obstruction and the Ministry of tubal interstitial, isthmic adhesions or occlusion of the limitations of its easy operation, recanalization rate, the best indication.
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