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Title: Tubal sterilization by selective catheterization in an animal model.
Author: Maubon A, Rouanet JP, Laurent A, Joujoux JM, Cover S, Courtieu C, Wassef M, Godlewski G, Honiger J, Lopez FM.
Journal: Invest Radiol; 1994 Feb; 29(2):156-61. PubMed ID: 8169090.
Abstract:
RATIONAL AND OBJECTIVES: The feasibility of tubal occlusion by selective salpingography was tested in an animal model; three novel occluding materials also were tested for this application. METHODS: Unilateral selective salpingography was performed in three groups of six rabbits; fallopian tubes were embolized with ethanol (group 1), a hydrogel (group 2), or an occluding emulsion (Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; tubal patency and histologic modifications were evaluated. RESULTS: Selective tubal catheterization was obtained in 100% of the cases. In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. CONCLUSION: Selective salpingography proved a suitable method for gaining access to the fallopian tube and allowed selective injection of occluding materials. More research is needed to determine a suitable occluding material, focusing on biocompatibility and on long-term efficacy. Unilateral selective salpingography was performed in 3 groups of 6 rabbits. 4-6 month old, virgin New Zealand White female rabbits were used with a mean weight of 4.4 kg. The fallopian tubes were embolized with ethanol (group 1); a viscous radiopaque solution which solidifies rapidly after injection to produce a biocompatible and inert hydrogel (group 2); or an occluding emulsion (a radiopaque heterogeneous alcoholic solution of zein, poppy seed oil, propylene glycol, and sodium amidotrizoate from Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; and tubal patency and histologic modifications were evaluated. Selective tubal catheterization was possible in all 18 cases, in 12 cases on the right side (66%), in 6 cases on the left side (33%); in 11 cases with a 5F catheter (61%), in 7 cases with a 2.5F catheter (39%). In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; and in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. The fallopian tubes were selectively catheterized over variable lengths: over 10 mm in 5 rabbits (28%), between 5 and 10 mm in 4 rabbits (22%), and between 1 and 5 mm in 9 rabbits (50%). Before injection of the occluding materials, all the catheterized tubes were patent. Mean volume of occluding material injected was 0.36 mL in group 1, 0.30 mL in group 2, and 0.83 mL in group 3. The ethanol injected reached the peritoneum in all 6 rabbits. The gel was injected an average length of 11 mm in the tube, while the emulsion opacified all the volume of the tubes with a peritoneal spill of emulsion in 3 of 6 cases. Reflux of occluding material into the uterus was noted in 1 of 6 rabbits in group 1, in 4 of 6 rabbits in group 2, in 3 of 6 rabbits in group 3. Selective salpingography proved a suitable method and allowed selective injection of occluding materials.

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