Lang E K, Dunaway H E, Roniger W E
Department of Radiology, Louisiana State University Medical Center, New Orleans 70112.
AJR Am J Roentgenol. 1990 Apr;154(4):735-40. doi: 10.2214/ajr.154.4.2107667.
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.
对157名不孕女性进行了选择性输卵管造影和经阴道导管扩张术，以诊断、定位和分类输卵管阻塞性疾病，并纠正输卵管近端（子宫端）阻塞。在61名（39%）患者中，尽管之前两次子宫输卵管造影显示输卵管近端（子宫端）阻塞，但选择性输卵管造影显示输卵管通畅。经阴道导管扩张术成功使96名输卵管阻塞患者中的79名（82%）输卵管近端再通。在25名经阴道导管扩张术成功且进行了6个月随访输卵管造影的患者中，有18名患者的输卵管仍保持通畅。29名（18%）患者被诊断出存在远端（卵巢端）输卵管并存疾病。157名患者中有11名成功怀孕（6名通过经阴道导管扩张术纠正了阻塞，5名选择性输卵管造影显示输卵管通畅）。该手术未出现并发症。这些经皮技术具有出色的诊断和治疗效果、无并发症且成本低廉，证明其可用于研究女性不孕症以及治疗输卵管子宫端阻塞。
