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A review of selective salpingography and fallopian tube catheterization. 总被引:17,自引:0,他引:17
A S Thurmond L S Machan A J Maubon J P Rouanet D M Hovsepian A Moore R J Zagoria K W Dickey J C Bass 《Radiographics》2000,20(6):1759-1768
Use of selective salpingography and fallopian tube recanalization has revolutionized the diagnosis and treatment of infertility. Selective salpingography, a diagnostic procedure in which the fallopian tube is directly opacified through a catheter placed in the tubal ostium, has been used since the late 1980s to differentiate spasm from true obstruction and to clarify discrepant findings from other tests. In fallopian tube recanalization, a catheter and guide wire system is used to clear proximal tubal obstructions. The recanalization procedure is simple for interventional radiologists to perform and is successfully completed in most patients (71%-92%). Pregnancy rates after the procedure have been variable, with an average rate of 30%. The combination of selective salpingography with fallopian tube recanalization has improved the overall management of infertility caused by tubal obstruction. The same catheterization technique used in fallopian tube recanalization is currently being explored for use in tubal sterilization. 相似文献
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选择性输卵管造影及输卵管阻塞的介入治疗 总被引:13,自引:1,他引:12
目的为明确输卵管阻塞部位,提供一种安全、可靠、成功率高的诊断和治疗方法。方法对50例23~38岁女性不孕症患者,确诊为两侧或单侧输卵管狭窄、粘连或闭塞,采用同轴导管系统,利用微导丝的机械作用和再通液的消炎、抗粘连等作用,疏通和治疗输卵管狭窄、阻塞或粘连病变。术后抗炎及定期输卵管通液治疗。结果插管成功率为92%,再通成功率为86.7%,无严重并发症。术后1年随访怀孕23例,达46%。结论选择性输卵管造影及再通术是诊治输卵管性不孕的一种微创有效的介入治疗技术。 相似文献
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Fallopian tube obstruction: selective salpingography and recanalization. Work in progress 总被引:5,自引:0,他引:5
Seven infertile women, in whom interstitial fallopian tube obstruction (IFTO) was suspected at hysterosalpingography and who were recommended for surgical evaluation and treatment, were treated with catheterization techniques. Selective salpingography with ostial injection demonstrated tubal patency in two patients; direct intratubal salpingography demonstrated patency in another patient. Four patients with a true IFTO underwent fallopian tube recanalization: in the first two, a small soft-tipped guide wire was used, and in the other two, a guide wire and 3-F catheter were used. The suggested catheterization techniques have the potential to make evaluation and treatment of IFTO more efficient, safer, and less expensive than presently used methods. 相似文献
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经宫颈选择性输卵管造影与再通术诊疗不孕症 总被引:2,自引:0,他引:2
目的分析应用导管经宫颈选择性输卵管造影的诊断价值;探讨输卵管阻塞再通术的机理和技术要领。材料与方法经常规碘油输卵管造影诊断为输卵管阻塞者96例,除2例外均成功地进行了选择性输卵管造影,56例确诊输卵管阻塞者施行了再通术。结果本方法造影证实31例双侧输卵管完全通畅,消除了假“阳性”,43例近端输卵管阻塞再通成功,6例中远端阻塞仅1例再通成功,再通成功率为78.6%,随访受孕率为28.6%。结论本方法诊疗输卵管阻塞及时、准确、简便、安全,再通成功率高,是输卵管不孕症者首选的一种有效、快捷诊疗方法。 相似文献
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Tubal obstruction after ligation reversal surgery: results of catheter recanalization 总被引:3,自引:0,他引:3
PURPOSE: To evaluate the role of transcervical fallopian tube catheterization in restoring tubal patency after ligation reversal surgery. MATERIALS AND METHODS: Twenty-four women with tubal obstruction after ligation reversal surgery underwent selective salpingography and tubal recanalization. RESULTS: Patency was established in 26 (68%) of 38 anastomotic tubes without complication. In the 13 patients who were followed up and who could conceive only via a recanalized anastomotic tube, there were six (46%) pregnancies: two (15%) successful uterine pregnancies, two (15%) early spontaneous abortions, and two (15%) tubal pregnancies. The mean time from procedure to conception was 2 months. CONCLUSION: Patency of fallopian tubes not visualized at hysterosalpingography after ligation reversal surgery can be established 68% of the time with selective salpingography. In some patients, selective salpingography can be therapeutic. If subsequent conception occurs in these patients, it occurs shortly after the catheterization procedure. 相似文献
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目的 探讨输卵管梗阻再通术中臭氧的应用效果.方法 经临床和实验室证实的输卵管梗阻患者116例,随机数字表法将患者分为研究组与对照组,每组各58例.所有患者住院期间均接受介入性输卵管再通术治疗.研究组应用臭氧水行输卵管灌注,而对照组则采用常规消炎及防粘连药物溶液.随访6个月,观察统计2组患者妊娠率及输卵管再闭塞率,同时于术后2周对2组患者不适症状进行评价并比较.结果 研究组输卵管再通成功率为93.1%(54/58),妊娠率为79.3% (46/58),再发闭塞率为5.2%(3/58).而对照组输卵管再通成功率为91.4%(53/58),妊娠率为60.3% (35/58),再发闭塞率为17.2%(10/58).分析显示,2组患者再通成功率差异无统计学意义(P>0.05),但研究组妊娠率及再发闭塞率显著高于对照组,差异具有统计学意义(P<0.05).研究组不适症状评分与对照组差异无统计学意义(P>0.05).结论 在输卵管再通术中采用臭氧灌注可有效提高术后妊娠率,降低再发闭塞. 相似文献
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Selective transcervical fallopian tube catheterization: technique update 总被引:15,自引:0,他引:15
A technique of transcervical fallopian tube catheterization involving use of a new vacuum hysterograph and coaxial catheter set is described. In 25 women, selective catheterization of the uterine cornua was accomplished with a 94% success rate. Ostial salpingography permitted visualization of 26% of the 46 tubes found to be obstructed or poorly visualized with conventional hysterosalpingography. Recanalization was successful in 96% of 28 proximal tubal obstructions and in 33% of six midisthmic obstructions unrelated to surgery. Recanalization attempts resulted in tubal perforations without apparent clinical effects in four tubes, one with proximal and three with midisthmic postsurgical obstructions. The new hysterograph with coaxial catheter set is more suitable for recanalization of the obstructed fallopian tubes than is the previously used balloon catheter set. 相似文献
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应用改良装置治疗输卵管阻塞(附800例分析) 总被引:1,自引:0,他引:1
目的 评价用一种改良装置对单侧或双侧输卵管阻塞的再通效果。方法 于1995年11月至2002年10月我院放射科对800例年龄为24~42岁不孕妇女经造影证实为单侧性或双侧性阻塞的1489条输卵管应用美国Cook公司产改良装置实施了介入再通术治疗。该技术操作是在X线监视下经宫腔将导管选送至输卵管开口端而进行选择性输卵管造影与输卵管再通术。结果 确诊有阻塞的1489条输卵管,经再通术治疗后,有1137条输卵管得以复通,复通率为76.4%,导管一次性插管成功率为98.8%。结论 用于输卵管再通术的改良装置兼具多方面优点,诸如操作灵活,疗效显,经济实用,因而值得推广。 相似文献
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目的:探讨梗阻输卵管治疗的有效途径及复通输卵管受孕的影响因素.方法:输卵管造影确诊的近段梗阻患者306例,利用输卵管再通装置先行输卵管再通术(FTR),对输卵管近段再通后显示远段积水粘连的68例,再施行腹腔镜伞端造口术.结果:306例近段输卵管梗阻经FTR治疗,除7例再通失败外,完全再通231例;近段再通后显示远段积水的68例接受腹腔镜伞端造口术.术后1~2个月造影复查输卵管通畅率为92.26%(465/504);追踪随访48个月受孕率为36.93%(113/306).结论:FTR联合腹腔镜治疗输卵管梗阻性不孕症疗效显著,两者通过优势互补有效地提高了输卵管的再通成功率,但经腹腔镜造口术复通的患者受孕率较低. 相似文献
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介入性输卵管再通术与输卵管加压通液治疗输卵管阻塞的比较 总被引:21,自引:0,他引:21
目的 使用介入性输卵管再通术治疗输卵管阻塞性不孕症,观察治疗效果,并与输卵管加压通液治疗本病的效果进行比较。方法 选观察组18例,输卵管36支;对照组10例,输卵管20支。观察组行选择性输卵管再通术,对照组仅用输卵管加压通液治疗。所有病例6个月后复查。结果 再通成功率观察组61.1%(22/36),对照组30.0%(6/20)。两者比较差异具有显著性意义(P<0.05)。再复发者观察组4支,对照组1支。结论 介入性输卵管再通术疗效显著优于传统输卵管加压通液治疗,该技术操作安全简单、成功率高,应作为治疗输卵管阻塞的首选方法。 相似文献
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H Shinmoto K Ido K Sumi T Nagai S Izumi Z Kondo Y Narimatsu M Izutsu Y Yuasa S Nakatsuka 《Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica》1991,51(2):143-148
Fallopian tube obstruction is one of the most difficult problems in the treatment of infertility. This report gives the results of a pilot study on the transcervical recanalization of the occlusive fallopian tube. Selective catheterization of the uterine cornu was applied through a balloon catheter, which was wedged at the internal uterine os. In 16 occlusive fallopian tubes of 11 cases, the catheterization procedure was attempted and accomplished with a 87.5% success rate. Recanalization was successful in 75.0% of the affected tubes. Subsequent pregnancy was confirmed in three cases. This convenient technique is safe and effective and it will be accepted as the first choice in the diagnosis and treatment of fallopian tube obstruction. 相似文献
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Purpose: To evaluate the technical success and outcome of fallopian tube recanalization (FTR) in salpingitis isthmica nodosa (SIN).
Methods: SIN is a well-recognized pathological condition affecting the proximal fallopian tube and is associated with infertility
and ectopic pregnancy. We reviewed the presentations, films, and case records of all patients attending for FTR for infertility
from 1990 to 1994. Technical success and total, intrauterine, and ectopic pregnancy rates at follow-up were determined.
Results: SIN was observed in 22 of 349 (6%) patients. FTR was attempted in 34 tubes in these 22 patients. Technical success was achieved
in 23 of 34 (68%) tubes affected by SIN. In 5 of the 11 failed recanalizations, failure was due to distal obstruction. At
least one tube was patent on selective postprocedural salpingography in 17 of 22 (77%) patients. There were no recorded perforations
or complications. At follow-up (mean 14 months), total, intrauterine, and ectopic pregnancy rates were 23%, 18%, and 4.5%,
respectively.
Conclusion: FTR in SIN is technically successful and, compared with previously reported results in unselected infertility patients, is
associated with only a slightly less favorable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. The findings
of SIN at FTR should not discourage attempted fluoroscopic transcervical recanalization.
Received: 0/00/00/Accepted: 0/00/00 相似文献
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Fluoroscopically guided transcervical fallopian tube recanalization of post-sterilization reversal mid-tubal obstructions 总被引:2,自引:0,他引:2
Houston JG Anderson D Mills J Harrold A 《Cardiovascular and interventional radiology》2000,23(3):173-176
Purpose: To assess the technical success and early outcome of fluoroscopically guided transcervical fallopian tube recanalization
(FTR) in mid-tubal occlusion following sterilization reversal surgery.
Methods: From July 1995 to January 1998, patients with greater than 12 months secondary infertility underwent hysterosalpingography
(HSG). FTR was performed in proximal or mid-tubal occlusion. Cases of FTR in mid-tubal occlusion were included in this study.
Technical success (defined as complete tubal patency) using a standard guidewire and hydrophilic glidewire, the number of
patients with at least one patent tube, and the intrauterine and ectopic pregnancy rates were determined.
Results: Twenty-six infertile patients with previous sterilization reversal underwent HSG. Eight of 26 (31%) patients (mean age 32
years, range 23–37 years), had attempted FTR for mid-tubal occlusion at the site of surgical anastomosis. Fourteen tubes were
attempted as there were two previous salpingectomies. Technical success was achieved in eight of 14 (57%) tubes attempted,
resulting in five of eight (62%) patients having at least one patent tube. At follow-up (mean 18 months, range 12–28 months)
in these five patients there was one intrauterine pregnancy. There were no ectopic pregnancies.
Conclusions: FTR in mid-tubal obstruction in infertile patients following sterilization reversal surgery is technically feasible and may
result in intrauterine pregnancy. In this small group there was a lower technical success rate and lower pregnancy rate than
in unselected proximal tubal occlusion. 相似文献
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目的:探讨利用自制装置对子宫显著屈曲合并输卵管梗阻的不孕患者进行输卵管再通术的插管方法并分析其疗效。方法:经子宫输卵管造影证实子宫显著屈曲伴单侧或双侧输卵管阻塞患者48例,共66争输卵管阻塞,应用自制装置,配合使用各种手术器械,施行选择性输卵管造影及再通术。采用复通率及妊娠率(随访2年)评价输卵管再通术的治疗效果,并将其与子宫位置正常患者进行比较。结果:48例患者均插管成功,施行再通术后,有56条输卵管复通,复通率为84.8%,随访2年后9例妊娠,妊娠率18.8%,妊娠率低于子宫位置正常患者,而复通率与子宫位置正常患者相近。结论:使用自制装置能够较方便完成显著屈曲子宫的输卵管再通术,各种手术器械的配合使用有利于成功插管。 相似文献
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K. Nakamura T. Ishiguchi H. Maekoshi Y. Ando M. Tsuzaka T. Tamiya N. Suganuma T. Ishigaki 《European radiology》1996,6(4):465-469
Clinical results of fluoroscopic fallopian tube catheterisation and absorbed radiation doses during the procedure were evaluated in 30 infertility patients with unilateral or bilateral tubal obstruction documented on hysterosalpingography. The staged technique consisted of contrast injection through an intraurine catheter with a vacuum cup device, ostial salpingography with the wedged catheter, and selective salpingography with a coaxial microcatheter. Of 45 fallopian tubes examined, 35 (78%) were demonstrated by the procedure, and at least one tube was newly demonstrated in 26 patients (87%). Six of these patients conceived spontaneously in the follow-up perod of 1–11 months. Four pregnancies were intraurine and 2 were ectopic. This technique provided accurate and detailed information in the diagnosis and treatment of tubal obstruction in infertility patients. The absorbed radiation dose to the ovary in the average standardised procedure was estimated to be 0.9 cGy. Further improvement in the X-ray equipment and technique is required to reduce the radiation dose.
Correspondence to: T. Ishigaki 相似文献
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Selective osteal salpingography and transvaginal catheter dilatation in the diagnosis and treatment of fallopian tube obstruction 总被引:11,自引:0,他引:11
Selective salpingography and transvaginal catheter dilatation were performed in 157 women with infertility to diagnose, localize, and classify obstructive diseases of the fallopian tubes and to correct obstruction of the proximal (uterine-end) tube. In 61 (39%) of the patients, the selective salpingograms showed patent tubes despite the fact that two previous hysterosalpingograms showed obstruction of the proximal (uterine-end) tube. Transvaginal catheter dilatation successfully recanalized the proximal portion of the tubes in 79 (82%) of 96 patients with obstructed tubes. In 18 of 25 with successful transvaginal catheter dilatation and 6-month follow-up salpingography, the tubes remained patent. Coexisting disease of the distal (ovarian-end) tubes was diagnosed in 29 (18%) of the patients. Pregnancy was achieved in 11 of the 157 patients (six in whom obstructions were corrected by transvaginal catheter dilatation and five in whom selective salpingograms showed patent tubes). There were no complications due to the procedure. The excellent diagnostic and therapeutic yield, lack of complications, and low cost justify the use of these percutaneous techniques to investigate female infertility and to treat obstruction of the uterine end of the fallopian tube. 相似文献