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Diagnostics · Tubal and Uterine Imaging

Selective salpingography and tubal catheterization in infertile women

El Fekih C, Ouerdiane N, Mourali M, Oueslati S, Binous N, Chaabane M, Ben Zineb N

Published March 2012 La Tunisie Medicale, 90(3), 233-237
PMID 22481195

RRM Academy Synopsis

Selective salpingography achieved tubal patency in 8 of 12 women

Selective salpingography opened blocked tubes in 8 of 12 women with proximal tubal blockage. This small 2012 case series from Tunisia followed women blocked near the uterus in both tubes. Four of the 8 women with open tubes conceived spontaneously within 4 to 12 months.

Key Findings

  • Among 180 women who had hysterosalpingography (an X-ray dye test of the tubes), 12 showed blockage at the uterine end of both tubes.
  • Eight of the 12 women reached patency. Contrast injection alone opened both tubes in 2 women, and tubal catheterization was needed in the other 6.
  • In 4 women, recanalization could not be done, and the proximal blockage remained after tubal catheterization.
  • Four women with successful procedures conceived spontaneously over 4 to 12 months and delivered healthy babies. The series reports no ectopic pregnancies and no serious complications.
  • Slight pain and nausea were the most frequent side effects.

Interpretation

This retrospective cohort study followed 12 women with bilateral proximal tubal blockage, treated at one hospital between 2002 and 2007 and followed for 4 to 12 months. Selective salpingography restored tubal patency in 8 of the 12 women, and 4 of those women conceived spontaneously and delivered healthy babies. The authors conclude the technique should be used more widely for bilateral proximal tubal blockage. The findings support larger studies of this approach.

RRM Context

Selective salpingography works on the blocked tube itself. That fits restorative reproductive medicine (RRM), which looks for the cause of infertility and treats it. IVF bypasses the tubes and leaves the blockage in place. The paper's discussion cites pregnancy rates after successful recanalization of 9% in a population with much distal tubal disease and 58% in one without it.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Use of selective salpingography (SS) and fallopian tube catheterization (TC) has revolutionized the diagnosis and treatment of proximal tubal infertility.

Aim

To evaluate results of women treated for proximal tubal obstruction by selective salpingography and tubal catherization.

Methods

Selective salpingography was performed in women with proximal bilateral tubal obstructions. Follow-up ranged from 4 to 12 months.

Results

twelve patients had been shown to have bilateral proximal obstruction of the fallopian tube. After SS/TC, patency was achieved in 8 cases. Spontaneous conceptions occurred in 4 women.

Conclusion

SS and TC should be used more widely because it is simple and effective in case of proximal tubal blockage.

Topics

Related research

Diagnostics › Tubal and Uterine Imaging › Hysterosalpingography · Infertility › Tubal Factor › Selective Salpingography · Reproductive Surgery › Tubal Surgery › Tubal Cannulation
Chiraz El Fekih, Nadia Ouerdiane, Mechaal Mourali, Seddik Oueslati, Naoufel Binous, Mounira Chaabane, Nabil Ben Zineb
C Fekih, N Ouerdiane, M Mourali, S Oueslati, N Binous, M Chaabane, N Zineb
PMID 22481195 22481195 El Fekih et al. 2012, El Fekih 2012

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