BALLOON TUBOPLASTY FOR FALLOPIAN TUBE OBSTRUCTION

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BALLOON TUBOPLASTY FOR FALLOPIAN TUBE OBSTRUCTION.

Using balloon catheters similar in design to those used for coronary angioplasty, gynecologists have begun treating proximal tubal occlusions in infertile women. In a multicenter trial of this new technique, 77 women with bilateral tubal occlusion underwent transcervical attempts to restore patency to their fallopian tubes. The procedures were done either on an outpatient basis or immediately after a diagnostic laparoscopy; all were performed under fluoroscopic guidance, with an average radiation time of 10 minutes.

In 92 percent of the cases, at least one tube was opened, and 69 percent of the women had patency restored to both tubes. Concomitant distal tube occlusion was diagnosed after proximal recanalization in 13 patients (17 percent); the researchers did not attempt recanalization of these distal occlusions. In the remaining 64 patients, 22 (34 percent) became pregnant during 12 months of follow-up; 17 of these pregnancies led to normal deliveries and 5 resulted in miscarriage. There has been only one ectopic pregnancy.

These data suggest that transcervical balloon tuboplasty is a safe and effective alternative to microsurgical tuboplasty or in vitro fertilization for women with proximal tubal occlusion. It is also likely to be less costly.

— THL

Published in Journal Watch General Medicine October 30, 1990