iothalamate-meglumine and Fallopian-Tube-Diseases

The authors evaluated the effect of different iodinated contrast agents on the fallopian tube and adnexal tissue in 15 rabbits. Ethiodized oil, an oil-soluble agent, was used in five rabbits. The following water-soluble agents were used: iothalamate meglumine 30% (n = 3), iothalamate meglumine 60% (n = 3), and ioxilan (n = 4). The agents were injected through catheters placed in the fallopian tubes. Fallopian tubes and peritoneal cavities were histologically evaluated. The contralateral tube served as a control. Ioxilan and iothalamate meglumine 30% produced no pathologic response in the tube or peritoneal cavity. Iothalamate meglumine 60% was associated with mild inflammatory infiltrate, mucosal edema, giant cell reaction, and periovarian adhesions that were bilateral but more pronounced on the injected side. Use of ethiodized oil resulted in papillary fibrous adhesions on the ovarian surface, and fat granulomas were seen in the periovarian tissues. The safety of oil-based contrast agents for use in hysterosalpingography is therefore questioned. No significant differences were found among the water-soluble contrast agents.

Topics: Adnexa Uteri; Adnexal Diseases; Animals; Contrast Media; Ethiodized Oil; Fallopian Tube Diseases; Fallopian Tubes; Female; Granuloma; Hysterosalpingography; Iohexol; Iothalamate Meglumine; Rabbits; Tissue Adhesions

Fluoroscopic transcervical fallopian tube recanalization was performed in 100 consecutive patients with infertility and proximal tubal obstruction documented with hysterosalpingography. In 86 patients, the procedure enabled at least one tube to be opened. Twenty-six intrauterine pregnancies resulted from the successful recanalization. A well-defined subset of 20 patients were evaluated to better define the treatment effect of fallopian tube recanalization. All 20 had bilateral proximal tubal obstruction without other tubal disease, and all had been recommended for tubal microsurgery or in vitro fertilization. Recanalization of one or both tubes was successful in 19 of these women (95%). Nine patients conceived (47%) without receiving any other therapy, and the average time from procedure to conception was 4 months. All pregnancies were intrauterine. Eight of the 10 patients who did not conceive underwent follow-up hysterosalpingography an average of 6 months following the procedure; four (50%) demonstrated reocclusion of both tubes. The authors conclude that nonsurgical fallopian tube recanalization is an effective treatment for infertility caused by proximal tubal obstruction.

Topics: Adult; Catheterization; Constriction, Pathologic; Dilatation; Fallopian Tube Diseases; Fallopian Tube Patency Tests; Female; Fluoroscopy; Follow-Up Studies; Humans; Hysterosalpingography; Infertility, Female; Iothalamate Meglumine; Middle Aged; Pregnancy; Recurrence