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  • Title: Transcervical recanalization of strictures in the postoperative fallopian tube.
    Author: Lang EK, Dunaway HH.
    Journal: Radiology; 1994 May; 191(2):507-12. PubMed ID: 8153330.
    Abstract:
    PURPOSE: To evaluate use of transcervical recanalization in patients with reocclusion of the proximal fallopian tube after failed surgery to reverse sterilization or failed tuboplasty to treat inflammatory disease. MATERIALS AND METHODS: The standard technique for transcervical recanalization was attempted in seven patients after failed reversal surgery and in 12 after failed tuboplasty. Four of seven patients with failed reversal surgery had fistular tracts and one also had a stricture; the remaining three patients and all 12 patients treated after failed tuboplasty and tube reimplantation had strictures at the site of implantation or anastomosis. RESULTS: Transcervical recanalization failed in all patients with fistulas but succeeded in 13 of 15 with stenoses. Three patients became pregnant 1-16 months after recanalization and two after in vitro fertilization and embryo transfer. Reocclusion occurred in two of 10 patients reexamined 6-36 months after recanalization. CONCLUSION: Transcervical recanalization is recommended as an alternative to repeat microsurgical reimplantation or tuboplasty. Transcervical tubal recanalization was performed in 19 patients in whom previous surgery had failed to reverse sterilization (n=7) or to reconstruct fallopian tubes obstructed from inflammatory disease (n=12). The patients were 25-41 years old, had been infertile for more than 18 months after the failed surgery and had no other clinical cause of infertility. 4 of the cases of failed reversal surgery had fistular tracts, and 1 also had a structure. The other 3 reversal patients and all 12 failed tuboplasty and tube reimplantation patients has strictures at the site of implantation or anastomosis. The standard technique for transcervical recanalization was followed. The transcervical recanalization only succeeded in 13/15 patients with stenoses. 3 of these became pregnant naturally 1-16 months after recanalization and 2 after in vitro fertilization and embryo transfer. Reocclusion occurred in 2 of 10 patients reexamined 6-36 months postoperatively. It was concluded that transcervical recanalization is a suitable alternative to repeat microsurgical reimplantation or to tuboplasty in cases such as these.
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