A prospective study on indwelling suture in preventing re-adhesion of fallopian tube after interventional recanalization / 中华放射学杂志

Objective To explore the clinical efficacy of indwelling suture in preventing re-adhesion of fallopian tube after fallopian tube recanalization(FTR). Methods Screen 93 patients with fallopian tube obstruction and FTR indications of prospective, the patients without other interference factors of infertility, they were randomized with random sampling into two groups (treatment group 50 and control group 43)and treated by FTR,then the treatment group with indwelling sutures in fallopian tube for 3 days, the control group were infused lipiodol into the tube and with a intrauterine cavity perfusion in 3 days. The two groups received followed up examination at 2,6 months after operation ( a treatment was repeated with the case of re-obstruction) . Follow-up for 12 months to appraise the pregnancy rate and the influence of pregnancy competence of tube with indwelling suture(6 months after operation, to collect and compare the pregnancy rate and ectopic pregnancy rate of patent tube in two groups). Results The tubal patency rate were 89.8%(53/59),89.5%(51/57)of treatment group at 2,6 months after operation and the control group were75.9%(44/58),75.0%(39/52), there was a significant difference between the two groups(2 m:χ2=4.027, P months after operation, the pregnancy rate and ectopic pregnancy rate of patent tube in treatment group were 21.6%(11/51),2/11, the control group were15.4%(6/39),1/6, there was no significant difference between them(pregnancy rate:χ2=0.552,P>0.05). Conclusions The indwelling suture of fallopian tube can prevent re-adhesion better after FTR, then improve the long-term recanalization rate and the pregnancy rate. There is no change on the pregnancy competence of fallopian tube.

Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention.

Clinical evaluation of tubal patency by transvaginal four-dimensional hysterosalpingo-contrast sonography / 中华医学超声杂志（电子版）

Objective To explore the clinical value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy)in evaluation of the patency of fallopian tubes. Methods Totally 53 patients underwent SonoVue TVS4D-HyCoSy to observe the tubal patency. Results Among the 106 tubes in 53 patients, TVS 4D-HyCoSy showed 47 unobstructed tubes, 23 obstructed tubes, and 36 partially passable tubes. In unobstructed cases, the fallopian tubes were smooth and regular in morphology, and contrast agents flowed into and dispersed over pelvic cavity rapidly and evenly. In the cases of partially passable tube, fallopian tubes were discontinuous and irregular in morphology, and contrast agents lfowed into and dispersed over pelvic cavity slowly and unevenly. In obstructed cases, there were no or little contrast agents into the fallopian tubes. Compared with the results of laparoscopy, the diagnostic accuracy of TVS 4D-HyCoSy was 94.4%(17/18). Conclusions TVS 4D-HyCoSy is a useful tool in demonstrating the morphological features of fallopian tube, diagnosing intrauterinc adhesion and lesion and assessing the tubal patency.

Endosalpingiosis in Postmenopausal Elderly Women

In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.

Observation on the effect of Zhuyun decoction combined with hysteroscopy intubation through liquid in the treatment of infertility / 中国基层医药

Objective To investigate the effect of Zhuyun decoction combined with hysteroscopy intubation through liquid in treatment of the oviduct obstructive infertility.Methods 114 cases with oviduct obstructive infertility were divided into the observation group and the control group according to different treatments,57 cases in each group.The control group was given hysteroscopic cannulation hydrotubation treatment,the observation group was given Zhuyun decoction on the basis of the control group.The clinical effects were compared between two groups.Results The total effective rate of the observation group was 75.4％,which was higher than 50.8％ in the control group(x2 =3.87,P ＜ 0.05).Fallopian tube dredging rate was 80.8％ in the observation group,which was significantly higher than 60.4％ in the control group (x2 =3.85,P ＜ 0.05).Pregnancy average gestation time was (9.5 ± 2.4) months in the observation group,which was significantly shorter than (11.2 ± 1.8) months in the control group (t =4.59,P ＜ 0.05).The improvement of pulsatility index (PI) and resistance index (RI) in the observation group was significantly better than those in the control group(t =3.12,2.25,all P ＜ 0.05).Conclusion Zhuyun decoction combined with hysteroscopy intubation through liquid can promote the oviduct obstructive infertility patients with fallopian tube dredging,increase pregnancy rate,shorten the time of pregnancy,and has no damage,which is worthy of clinical application.

Analysis of the effect of laparoscopic salpingostomy in the treatment of infertile caused by hydrosalpinx / 中国基层医药

Objective To analyze the effect of laparoscopic salpingo.stomy in the treatment of infertile caused by hydrosalpinx,and explore the reasonable treatment method for improving pregancy rate.Methods 130 infertile women with hydrosalpinx were treated with salpingostomy firstly,some unsuccessful cases were treated with salpingectomy.The pregnancy rate between successfully salpingostomied patients and unsuccessfully salpingostomied patients was also compared.Results 85 cases were salpingostomied successfully,the successful rate was 65.4％,among these patients 40 received IVF-ET,there was no difference in the natural pregnancy rate between singly hydrosalpinx (17.9％) and double hydrosalpinx(16.7％) (x2 =0.06,P ＞ 0.05),but the artificial pregnancy rate in single hydrosalpinx(70.0％) was higher than double hydrosalpinx (35.0％) (x2 =4.912,P ＜ 0.05).Among 45 unsuccessfully salpingostomied patients,14 cases underwent salpingectomy,all patients received more than two times of IVF-ET treatment,the pregnancy rate in salpingectomied patients (21.4％) was higher than unsalpingectomied (3.2％) (x2 =3.946,P ＜ 0.05).The artificial pregnancy rate of successfully salpingostomied patients (52.2％) was higher than unsuccessful patients (21.4％) (x2 =4.055,P ＜ 0.05).Conclusion Salpingostomy can raise the pregnancy rate (natural or artificial),it is beneficial to do salpingectomy for unsuccessfully salpingostomied patients who want to receive IVF-ET.

Qual o papel do Toll-Like Receptor (TLR) na indução de lesão de tuba uterina nas infecções por Chlamydia Trachomatis? / What is the role of Toll-Like Receptor (TLR) in the induction of tubal damages caused by Chlamydia Trachomatis infection?

A suscetibilidade à infecção por C. trachomatis, curso, complicações e resolução da doença depende do tipo da bactéria, de fatores ambientais eda genética do paciente. Entre as mulheres uma forma frequente da infecção é a endocervicite, que pode se complicar com salpingite com consequente lesãotubária. Acredita-se que as complicações a longo prazo desta infecção ocorrem via heat shock protein HSP 60 e toll-like receptors (TLR)...

The susceptibility, course, complications and outcome of Chlamydia trachomatis infection depends on the type of bacteria, environmentalfactors and host genetic factors. Among women, the most common infection is cervicitis that can be complicated by salpingitis leading to tubal damage.It is believed that long-term complications occur via HSP 60 and toll-like receptors...

Application of fallopian tube embolization before in vitro fertilization and embryo transfer dealing with the hydrosalpinx / 中华妇产科杂志

Objective To explore the effectiveness of the fallopian tubes embolization for the hydrosalpinx before in vitro fertilization and embryo transfer(IVF-ET).Methods The fallopian tubes embolization was performed on 46 hydrosalpinx patients-Fimt the hysterosalpingography was performed to show the positions and shape of the hydrosalpinx.Then the hydrops was drawn into the celiac cavity in order to be absorbed after performing fallopian tube recanalization. Finally,transv(o)ihal therapy was performed,putting the embolization microcoils into the fallopian tube through a micro-catheter.One month after the fallopian tubes embolization,hystemsalpingography was conducted to check for the effectiveness of the embolization.After 3 months.all the 46 patients received the treatment of IVF-ET,Results The interventional treatment of 82 fallopian tubes obtained one time success among 46 cases of fallopian tubes embolization.Among them,obvious results were achieved in 72 fallopian tubes,taking up 88%0f tIle total;effective results were seen in 10 fallopian tubes.accounting for 12%0f the total.No one was invalid.In the same period,compared with the 91 cases of non-hydrosalpinx as the control group.the embolization group of patients achieved a higher fertilization rate(69%),and clinical pregnancy rate(41%),compared with the control group(63%and 39%respectively),but without a significant difference(P>0.05).However,the ectopic pregnancy rate(O)and the abortion rate(8%)were significantly lower than the control group(8%,16%respectively;P<0.05).Conclusions Fallopian tubes embolization used in hydrosalpinx treatment before IVF-ET is an innovative approach,simple,safe,economical,with no negative impact on ovarian functiorr It can significantly increase the clinical pregnancy rate and prevent the occurrence of tubal pregnancy.It is a feasible and effective method.

The treatment patients with infertility reformed-fallopian tube obstruction hy two methods / 中国基层医药

Objective To study the clinical the rapeutic efficacy of reformed-fallopian tube recanalization (RFTR) with Chinese traditional medicines for treatment of infertility resulted from fallopian tube obstruction.Methods 80 patients of infertile women with fallopian tube obstruction were randomly divided in to the treated group( n = 40, treated with RFTR combined with Chinese traditional medicines) and the control group( n = 40,treated with RFTR alone). All cases were followed up for 6 to 12 months. The efficacy rate,pregnancy rate,ectopic pregnancy rate and the re-adhension rate were recorded in both groups. Results The efficacy rate of treated group and the control group were 72.5 % and 57.5 % respectively, with statistical significance( P < 0.05 ). The pregnancy rates of the two groups were 52.5 % and 30.0 % respectively. The ectopie pregnancy rate of the two groups were 5 % and 7.5 % respectively. Conclusion RFTR with Chinese traditional medicines therapy is an effective method to treat in fertility resulted from fallopian tube obstruction.

Clinical analysis of fallopian tube prolapse after hysterectomy / 中华妇产科杂志

Objective To investigate the clinical diagnosis,treatment and prevention of fallopian tube prolapse(FTP)after hysterectomy.Methods A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital,including 6229 cases of trans-abdominal hysterectomy(TAH),780 cases of transvaginal hysterectomy(TVH),and 940 cases of laparoscopic assisted vaginal hysterectomy(LAVH).Nine cases(including 1 case from other hospital)of FTP after hysterectomy were analyzed retrospectively for their symptoms,diagnosis and treatment.All of them were diagnosed according to the results of histology and follow-up.Results The overall incidence of FTP after hysterectomy was 0.11%(9/7949).Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229),after vaginal hysterectomy 0.51%(4/780),and after laparoscopic assisted vaginal hysterectomy 0(0/940).There were no symptoms in 3 cases,but the other 6 cases had symptoms.The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases.All of them were excised vaginally and cauterized.The results were confirmed by histological examination.No recurrent cases were reported in follow up.Conclusions FTP is a rare complication after hysterectomy.The prognosis is well after proper diagnosis and treatment.Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.