Application of liquid pressurization under obstruction of healthy-side uterine horn with catheter tip combined with guidewire recanalization in treating unilateral obstruction of fallopian tube / 介入放射学杂志

ABSTRACT

Objective To investigate the clinical application of liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter combined with guidewire recanalization in treating unilateral obstruction of fallopian tube.Methods Hysterosalpingography was performed in infertility patients.A total of 50 patients with unilateral obstruction of fallopian tube were selected.Attempt was made to use catheter tip to obstruct the healthy-side uterine horn,then liquid pressurization was carried out to reopen fallopian tube,and the relationship between the success of recanalization and uterine morphology was analyzed;further guidewire recanalization was employed when liquid pressurization method failed,and the recanalization rate was calculated.Results In 33 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was shorter than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was smaller than the catheter diameter,thus the uterine horn was tightly occluded by the catheter tip.Recanalization of the fallopian tube was obtained in 19 patients,and recanalization of the fallopian tube failed in 14 patients because the obstruction was very severe.In 17 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was longer than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was larger than the catheter diameter,thus the uterine horn could not be tightly occluded by the catheter tip,resulting failure of recanalization of fallopian tube.Further guidewire recanalization had to be carried out for the 33 patients whose recanalization of fallopian tube with liquid pressurization method failed,and recanalization of fallopian tube was achieved in 22 patients.Conclusion Liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter can reopen the obstructed fallopian tube in some patients,and the success of recanalization is closely related to the uterine morphology.Additional use of guidewire recanalization technique can significantly improve the recanalization rate for unilateral fallopian tube obstruction.