Hilgers, T. W., & Yeung, P. P., Jr. (1999). Intratubal pressure before and after transcervical catheterization of the fallopian tubes. Fertility and Sterility, 72(1), 174-178. https://doi.org/10.1016/s0015-0282(99)00165-x
Hilgers TW, Yeung PP Jr. Intratubal pressure before and after transcervical catheterization of the fallopian tubes. Fertil Steril. 1999;72(1):174-178. doi:10.1016/s0015-0282(99)00165-x
Hilgers, Thomas W., and Patrick Yeung, Jr. "Intratubal pressure before and after transcervical catheterization of the fallopian tubes." Fertility and Sterility, vol. 72, no. 1, 1999, pp. 174-178.
For EndNote, Zotero or Mendeley:
Open access
Free to read
No reuse license
Free to read at the publisher (reported by Unpaywall and OpenAlex, not verified by RRM Academy)
Blocked fallopian tubes had higher pressure that fell after a catheter
Fallopian tubes with more blockage had higher pressure. A prospective study at one center measured it in 234 women with infertility. After a catheter passed through, about 8 out of 10 partly blocked tubes and about 3 out of 10 fully blocked tubes had normal pressure.
Key Findings
Selective hysterosalpingography measured pressure in 441 tubes: 110 freely patent, 77 completely obstructed, the rest partially obstructed. Pressure was lowest in freely patent tubes and highest in completely obstructed tubes.
Of 234 women, 106 had selective hysterosalpingography only and 128 had both it and transcervical catheterization of the fallopian tubes (TCFT). Pressure was recorded after TCFT in 212 cases.
Among partially obstructed tubes with high pressure before TCFT, 76% had normal pressure after TCFT. Among 44 completely obstructed tubes, 29.5% did.
In 25 women with complete obstruction, surgery to remove the blocked segment and rejoin the tube found an organic cause in every case. Diagnoses included salpingitis isthmica nodosa (10) and endometriosis (8).
The authors observed no perforations, infections or other complications. Fluoroscopy time, recorded for 48 consecutive procedures, averaged 138 seconds.
Interpretation
This prospective procedural study followed 234 women with infertility. Pressure fell after the catheter in most partly blocked tubes, and in about a third of fully blocked tubes. Surgery on fully blocked tubes found a physical cause each time. The authors note they did not calculate pregnancy rates. The findings support larger studies of catheterization and pregnancy outcomes.
RRM Context
RRM looks for the cause of infertility first. Selective hysterosalpingography checks the tubes for a physical cause of blockage. In 25 women with fully blocked tubes who had surgery, a physical cause turned up every time. Evaluation includes both partners.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To assess the intratubal pressure (ITP) and patency status of the fallopian tubes before and after transcervical catheterization of the fallopian tubes (TCFT).
Design
Prospective procedural assessment.
Setting
Pope Paul VI Institute for the Study of Human Reproduction.
Patients
Two hundred thirty-four women with either primary or secondary infertility.
Interventions
Patients underwent selective hysterosalpingography and, in some cases, TCFT with measurement of the ITP before and after the procedure.
Main Outcome Measures
The ITP before and after TCFT.
Results
The mean (+/-SD) ITP in freely patent tubes was 0.53 +/- 0.06 atm, that in partially obstructed tubes was 1.23 +/- 0.52 atm, and that in completely obstructed tubes was 2.79 +/- 1.40 atm. After TCFT, the mean (+/-SD) ITP in partially obstructed tubes decreased to 0.64 +/- 0.31 atm and that in completely obstructed tubes decreased to 1.86 +/- 1.35 atm. The ITP was normalized in 76% of partially obstructed tubes and in 29.5% of completely obstructed tubes. In all cases of complete obstruction in which surgical correction was attempted, organic pathology was identified.
Conclusions
The procedure described is a safe and easy means of obtaining reliable and significant information on the status of the proximal fallopian tube.
