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Fallopian tubes: improved technique for catheterization 总被引:8,自引:0,他引:8
Successful fallopian tube catheterization for diagnosis or treatment of infertility combines hysterosalpingographic and angiographic techniques. An improvement in the catheterization strategy was developed so that angled, tortuous, or more distally obstructed fallopian tubes could be catheterized. In 22 patients, 38 fallopian tubes were catheterized by using this strategy. In nine tubes (24%), forceful ostial injection alone of contrast material was able to open and/or depict the fallopian tube. In 13 tubes (34%), a discrete obstruction was recanalized by using the standard fallopian tube catheterization set. In 12 tubes (32%), successful recanalization required the use of a softer, tapered guide wire and catheter. In four tubes (10%), recanalization was unsuccessful. 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
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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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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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Occlusion of the fallopian tube by selective transcatheter radiofrequency electrocoagulation: an experimental study in rabbits 总被引:1,自引:0,他引:1
Seo TS Oh JH Yoon Y Ryu KN Lim JW 《Journal of vascular and interventional radiology : JVIR》2002,13(4):399-404
PURPOSE: To test the feasibility of performing transcervical fallopian tube occlusion in a rabbit model with use of unipolar radiofrequency (RF) electrocoagulation. MATERIALS AND METHODS: Under fluoroscopic guidance, transvaginal catheterization of the right or left fallopian tube was first performed with use of a coaxial technique in 20 rabbits. With a metal guide wire protruding from the catheter serving as the active electrode, RF electrocoagulation was performed. The power output was set to 200 W and the current was applied for 20 seconds. The fallopian tube on the contralateral side and the uterus were used as controls. Rabbits were randomly designated to be killed either 2 days (group I, n = 10) or 30 days (group II, n = 10) after the procedure, and tubal patency and histologic changes were evaluated. RESULTS: In group I, significant necrosis of the endosalpinx caused by RF electrocoagulation was found in all 10 rabbits. In group II, the occluded fallopian tube showed fibrosis of the wall in all 10 rabbits, but there was no tissue damage to adjacent organs. Histologic findings in the contralateral fallopian tubes were normal in all 20 rabbits. CONCLUSION: Transcatheter RF electrocoagulation proved to be a safe nonsurgical alternative for occlusion of the fallopian tubes in rabbits. 相似文献
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A S Thurmond J R?sch P L Ross B T Uchida R M Scanlan P E Patton 《Investigative radiology》1988,23(11):818-821
A rabbit model for testing the safety and effectiveness of diagnostic and interventional techniques of fallopian tube catheterization is presented. Hysterography with injection into the terminal portion of the uterine horn visualized the fallopian tube in only 6% of cases; however, this increased from 33% to 50% by pretreatment with progesterone, administration of glucagon or phentolamine, or increased pressure of injection with balloon obstruction of the uterine horn. Salpingography with a catheter introduced in the tubal ostium or directly inside the tube was most effective and resulted in a consistent (100%) visualization of the fallopian tube. The technique also allowed coaxial introduction of small diameter guidewires and catheters deep into the fallopian tube. 相似文献
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Use of ethylene vinyl alcohol copolymer for tubal sterilization by selective catheterization in rabbits 总被引:1,自引:0,他引:1
Abdala N Levitin A Dawson A Maffra R Munoz-Ramirez H Godec K Dolmatch BL 《Journal of vascular and interventional radiology : JVIR》2001,12(8):979-984
PURPOSE: To assess the efficacy of ethylene vinyl alcohol copolymer (Uryx) in nonsurgically occluding the fallopian tube and achieving tubal sterilization in the rabbit model. MATERIALS AND METHODS: Ten mature virgin female New England rabbits underwent transvaginal selective bilateral fallopian tube cannulation with use of a coaxial catheter system under general anesthesia. Selective salpingography was performed bilaterally to assess patency of the fallopian tubes. Ethylene vinyl alcohol copolymer was injected unilaterally through a microcatheter to completely fill the middle portion of the tube. Three to seven days after injection, each animal was bred. Conception was determined by ultrasonography (US) 7-19 days after effective breeding. If pregnant, the rabbit was killed. Otherwise, it was permitted to rebreed until pregnancy was achieved. Histologic specimens of the fallopian tubes were prepared and analyzed. RESULTS: Patency of the fallopian tubes was demonstrated bilaterally in all animals by the free spillage of contrast material into the peritoneum. The delivery of ethylene vinyl alcohol copolymer into the fallopian tubes was successful in all animals but one, in which most of the plug almost immediately extruded into the uterus. Pregnancy was detected by US in the untreated fallopian tube in the nine rabbits that were receptive to breeding. No pregnancies were detected in the injected side. Histologic analysis demonstrated variable degrees of occlusion, fibrosis, and inflammation, with the majority of specimens demonstrating mild to moderate inflammation and moderate to marked fibrosis. CONCLUSION: Ethylene vinyl alcohol copolymer can reliably be placed nonsurgically via the transvaginal approach into the fallopian tubes with use of a coaxial catheter system. Ethylene vinyl alcohol copolymer appears to result in less fibrosis than previously investigated agents and demonstrates a 100% early sterilization rate in the rabbit model. 相似文献
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目的:探讨Mencini双球囊导管系统配合单弯导管在输卵管再通治疗中的应用价值。方法:120例患者介入术中因子宫倾曲等原因而致选择性插管难以到达目标输卵管时,即换用单弯导管行选择性插管。结果:更换导管后,全部病例均成功地完成选择性输卵管插管,平均插管时间仅12s。结论:选择性输卵管插管是输卵管阻塞再通成功的关键,应用Mencini双球囊导管系统配合单弯导管能较好地消除妨碍选择性输卵管插管的不利因素,值得临床推广应用。 相似文献
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目的探讨改良双腔球囊导管在插管失败的输卵管阻塞介入再通术中的应用价值。方法回顾45例输卵管阻塞性不孕患者,应用常规法行介入再通术,其中输卵管开口插管失败采用改良双腔球囊导管行介入再通,统计分析常规法组与联合改良双腔球囊导管法组(联合法组)的输卵管开口插管成功率、输卵管阻塞的开通率。结果输卵管阻塞性不孕患者45例,共阻塞输卵管90条,采用常规法输卵管开口插管成功32条,其中开通成功31条,插管成功率为35.56%,开通率96.88%。采用联合法输卵管开口插管成功90条,输卵管开通83条,插管成功率为100%,开通率92.22%,7条输卵管因阻塞病情严重无法开通,其中双侧均未能开通1例。所有患者术中均无严重并发症发生。随访12个月,妊娠率48.65%。常规法组与联合法组输卵管开口插管成功率差异具有统计学意义(χ^2=85.574,P=0.000),而输卵管开通率差异无统计学意义(χ^2=0.248,P=0.619)。结论对于常规法输卵管开口插管失败者,采用联合改良双腔球囊导管可提高输卵管开口插管成功率。采用改良双腔球囊导管介入再通与常规法开通效果相当,可作为常规介入再通输卵管开口插管失败的备选方案。 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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简化器械开展输卵管再通治疗的探讨(附 38例报告) 总被引:3,自引:0,他引:3
目的:采用简化器械及手术方法开展输卵管再通术治疗输卵管阻塞,探讨其方法的临床意义和效果。采用Cook公司6F直型导管或其它6F导管改制作介入导管,Terumo公司超滑导丝做再通器械,治疗患者36人共38例次,经造诊断输卵管不能共64条,结果:输入卵管实现再通54条,再通有效率达84.37%,其中有2例采用腹腔镜结合管再通术实现再通,1例输卵管再通后8个月造影发现重新阻塞。结论:采用简化芨手术方法进行输卵管介入再操作简便,费用低,是一种治疗输卵管阻塞病变安全有效的方法。器械及手术方法的简化不但降低费用,且能达到理疗效。 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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输卵管再通术与导管留置治疗输卵管阻塞的初步研究 总被引:3,自引:0,他引:3
目的:为研究输卵管阻塞性不孕症,采用再通术后留置导管法,观察其治疗效果。方法:选观察组10例,输卵管20支;对照组18例,输卵管36支,选择性输卵管再通术和药物通液后,观察组留置导管48h,对照组仅用导管通液,所有病例6个月后复查。结果:再粘连率对照组23.8%,观察组8.3%。结论:输卵管再通术与导管留置可有效治疗输卵管阻塞,防止再粘连。 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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Ultrasound-guided fallopian tube catheterization was performed in seven women a total of 14 times. The women had normal-appearing fallopian tubes at hysterosalpingography and received sperm via the catheter as a way to overcome their inability to conceive. Techniques similar to those used for fluoroscopically guided fallopian tube catheterization were used. Forty-three percent of fallopian tubes were successfully catheterized. 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