Fallopian Tube Recanalization (Cannulation)
Fallopian tube recanalization (tubal cannulation) is a minimally invasive procedure that restores patency to a proximally blocked fallopian tube by passing a small catheter transcervically through the uterine cavity and into the tube under fluoroscopic or hysteroscopic guidance. Proximal tubal occlusion, located near the uterotubal junction, is distinct from distal disease and is frequently caused by mucus plugging, amorphous debris, or inflammatory fibrosis. A significant proportion of apparent proximal occlusions identified on HSG are not true anatomical blocks; recanalization resolves these in many cases in a single outpatient procedure without surgery.
Clinicians perform the procedure via selective salpingography: they guide a catheter to the blocked cornual ostium, dye is injected under pressure to confirm the location, and a guide wire or small catheter is advanced to open the occlusion. Intratubal pressure measurement before and after cannulation confirms successful recanalization.1 When combined with hysteroscopy, the clinician can visualize the ostium directly. When performed under fluoroscopy in an interventional radiology setting, it can be done without general anesthesia.
Because proximal tubal occlusion accounts for a meaningful proportion of tubal-factor infertility diagnoses, recanalization matters as a restorative option. It avoids the surgical morbidity of open tubal anastomosis and preserves the tube for natural conception attempts afterward. Recurrence of occlusion is possible, and a repeat HSG or sonohysterogram after adequate recovery time confirms ongoing patency before attributing persistent infertility to tubal causes.
See also: selective salpingography, transcervical catheterization, HSG, tubal-factor infertility, intratubal pressure.
Cited in this entry
- Hilgers TW, Yeung P. Intratubal pressure before and after transcervical catheterization of the fallopian tubes. Fertil Steril. 1999. https://rrmacademy.org/library/intratubal-pressure-before-and-after-transcervical-catheterization-of-the-fallop-rec1fplphsqpn4kaw/
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