Hysteroscopic Tubal Catheterization for Treatment of Infertility with Proximal Tubal Occlusion

Jeong, J; Oh, S T; Lee, H S

Abstract

The purpose of this study is to evaluate the efficacy of modified hysteroscopic catheterization for treatment of proximal tubal occlusion. This study was performed in 17 patients who were dignosed to proximal obstructions of both tubes by hysterosalpingography (HSG) from January 1st., 1994 to october 31st, 1997. Hysteroscopic catheterization could be performed without concomittent laparoscopy, because observation of dye-flow in uterine cavity was possible by gentle injection of dye through the catheter and by gentle control of continuous expansion media flow. On hysteroscopic exam, 4 of 17 patients revealed the normal ostia without any fibrosis and they seems to be obstruction by spasm or by microplug. 6 of 17 patients showed mild fibrosis, and the other 7 patients revealed the severe fibrosis of ostia. Catheterizations of ostia were easily succeed in all 4 no fibrosis patients and 6 mild fibrosis patients. In 6 patients of severe fibrosis, catheterizations were succeed although they were very difficult. However in one patients of severe fibrosis, fibrosis of ostia was too hard to pass the catheter. Therefore overall success rate was 94% (16 of 17 patients). In follow-up one month later by HSG, 2 patients of no fibrosis revealed proximal occlusion findings of both tubes again. In coclusions, this modified hysteroscopic catheterization is simple and effective method for diagnosis and treatment for proximal obstruction of fallopian tube.