Fallopian Tube Occlusion by Selective Transcatheter Radiofrequency Electrocautery

PURPOSE: To access the usefulness of transcatheter radiofrequency(RF) electrocautery as a method ofnonsurgical tubal occlusion. MATERIALS AND METHODS: Using the coaxial technique under fluoroscopic guidance,transvaginal fluoroscopic fallopian tube catheterization was performed in thirteen rabbits. In each rabbit,unilateral tubal ablation was performed using RF electrocautery. A 0.018 inch metallic wire protruding from themicrocatheter tip was used as the source of the RF energy ; the length of the noninsulated part of this wire was10mm and the duration of RF supply was 20 seconds. The contralateral normal fallopian tube and uterus were used asa control. All 13 rabbits were randomly sacrified on two days(group I) or 30 days(group II) after the procedure,and tubal patency and histologic change were evaluated. RESULT: In group I(n=5), significant RF ablation-inducedtissue necrosis of the endosalpinx was found in all five rabbits. In group II(n=8), the fallopian tube wascompletely occluded with tubal wall fibrosis, in all eight rabbits, but there was no tissue damage in adjacentperitoneal organs. For contralateral control tubes, the histologic findings were normal. CONCLUSION: Transcatheter RF electrocautery is thought to be a useful method for tubal occlusion. It is simple, safe, and lessexpensive and might have a role in future female tubal steralization.

Comparison of the Success Rate of Recanalization According to Morphologic Patterns in Proximal Obstructed Fallopian Tube

PURPOSE: To compare the success rate of recanalization in three types of the proximal fallopian tube obstruction. MATERIALS AND METHODS: Transcervical fallopian tube catheterization (TFTC) was performed in 141 infertile patients with 239 fallopian tube obstruction. Three-coaxial catheter and 0.018 inch guide wire(Terumo, Tokyo, Japan) were employed for the recanalization. The obstructed proximal fallopian tubes were divided into three groups according to the appearance of the distal end of obstructed fallopian tubes : smooth tapering, concave, or convex. RESULTS: Recanalization was successful in 151 of 239 tubes(63.2%) ; success rates were 82.7%(62/75) in the smooth tapering group, 80.2%(69/86) in the concave, and 25.6%(20/78) in the convex. In theproximal portion, success rates were 80.3%(53/66) in the smooth tapering group, 82.6%(38/46) in the concave, and 48.5%(16/33) in the convex. Eighty-nine patients were successfully recanalized. Sixty-four of 89 patients were followed-up for more than one year and 29 patients(45%) became pregnant. Complications occurred in 37 tubes, tube perforation in 32, re-obstruction in five, and ectopic pregnancy in one. CONCLUSION: The success rate of recanalization of an obstructed proximal fallopian tube was higher in smooth tapering and concave types than inthe convex type.