Laparoscopic guided transcervical hysteroscopic tubal cannulation in the treatment of proximal tubal block

ABSTRACT

Proximal tubal obstruction [PTO] represent up to 25% of tubal disease in infertile women. Hysteroscopic tubal cannulation, tubal reanastamosis and IVF are the available modalities for the treatment of PTO The aim of this study is to evaluate the value of treatment of PTO using hysteroscopic tubal cannulation under laparoscopic guidance. Randomized study, Bab El Sharia University Hospital. Thirty infertile patients [either primary or secondary infertility] due to PTO as evidenced by hysterosalpingography were recruited from infertility clinic. Duration of infertility, history of pelvic inflammatory disease and any methods of contraception were asked for. Immediately after menstruation combined laparoscopy and hysteroscopic tubal cannulation were done for each patient. Hysteroscopic tubal cannulation successfully re-established tubal patency in forty [83.33%] out of forty eight tubes originally diagnosed with PTO. No significant relation between success of recanalization and either of duration of infertility, history of PID, method of contraception or type of infertility. There was significant relation between incidence of tubal perforation and duration of infertility as well as history of IUD