Diagnosis and treatment of proximal tubal obstruction by fluoroscopic transcervical fallopian tube catheterization.

The efficacy of fluoroscopic transcervical Fallopian tube catheterization in treating patients with proximal tubal obstruction was investigated. In 11 (15.9%) of the 69 patients who entered the study, patency of the proximal Fallopian tubes was shown by a pre-treatment hysterosalpingogram or an ostial selective salpingogram. Transcervical Fallopian tube catheterization attested to the success of recanalization in at least one of the obstructed tubes in 41 of our 58 patients (70.7%). Of 92 obstructed tubes, 56 (60.9%) were successfully recanalized. However, normal tubal visualization was possible in only 13 tubes (23.2%). Most of the recanalized tubes were considered to be peritubal adhesions (64.3%). Eight of 36 (22.2%) patients who had been successfully recanalized achieved pregnancies; 12 patients demonstrated normally appearing salpingograms after the procedure, and five (41.7%) had an intra-uterine pregnancy. Suspected peritubal adhesions were exhibited on post-operative salpingograms of 24 patients, one of whom had an intra-uterine pregnancy, while two had tubal pregnancies. Transcervical Fallopian tube catheterization is a simple and effective method for evaluating and treating proximal tubal obstruction. Most of the patients (70.7%) in whom recanalization was successful showed significant signs of distal tubal damage. This procedure can also be used to arrive at a prognosis regarding conception.