Transcervical Tubal Cannulation
Bilateral or unilateral proximal tubal obstruction (PTO) is a common finding on a hysterosalpingogram (HSG) obtained as a part of the infertility workup. The traditional management of this radiologic finding is laparoscopic assessment of the oviducts. If no spill of transcervically injected contrast is noted from the fimbriated end of the fallopian tube, microsurgical resection of the obliterated segment of the oviduct and anastomosis is performed. HSG alone has a nearly 40% false-positive rate, and PTO is often overdiagnosed. Laparoscopic evaluation of PTO does not eliminate the false-positive rate. Serious pathology is found in only 40% of the microsurgically resected tubal segments, and amorphous casts, calcifications, or a patent lumen are the findings in the remaining 60% of the excised oviducts. Therefore the need for major abdominal surgery can be questioned in such cases.
KeywordsFallopian Tube Ectopic Pregnancy Uterine Cavity Heavy Menstrual Bleeding Tubal Patency
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