Tubal sterilization by means of endoluminal coagulation: an in vivo study in rabbits

Non-suture technique for rabbit oviduct anastomosis with 2-octyl cyanoacrylate: a histopathologic and biomechanical analysis

AIM

The aim of this study was to investigate histological and biomechanical properties of oviduct anastomosis with 2-octyl cyanoacrylate (OCA) in the rabbit.

MATERIAL AND METHODS

Sixty female rabbits were randomly divided equally into three groups: A (control), B (traditional catgut suture), and C (non-suture technique using OCA). After suture or OCA anastomosis, gross examination (adhesion formation) and histopathology (hematoxylin-eosin), ultrastructure (transmission electron microscopy), and biomechanics (bursting pressure) on para-anastomotic site were investigated on oviduct taken at 1 (A1, B1, C1) and 4 (A2, B2, C2) weeks, respectively.

RESULTS

Adhesion score in group B was more severe than that in groups A and C at 1 and 4 weeks. Histopathology showed that acute endosalpingitis in group B was the most intense at 1 week, followed by significantly more tissue stimulation induced by catgut and foreign-body giant cells in group B than in group C at 4 weeks. Ultrastructural damage of ciliated cells was reversed partly (B2) and completely (C2) at 4 weeks. Bursting pressure in C1 was weaker than that in B1, followed by no significant difference at 4 weeks.

CONCLUSION

Non-suture using OCA for oviduct anastomosis can be accepted as a new-perspective technique.

Hysteroscopy and the butyl-cyanoacrylate on experimental sterilization of rabbit uterine tubes

PURPOSE: To assess the sterilization effectiveness on uterine tube of rabbit by the cyanoacrylate adhesive. METHODS: Hysteroscopy tubal catheterization was performed randomly in 12 animals (24 uterine tubes) assigned to the sham group (GS) and 15 animals (30 uterine tubes) to the n-butyl-cyanoacrylate (GB). The female rabbits were observed during 30, 90 and 180 days and mated to fertile males. The no pregnant rabbits were submitted to in vitro burst pressure test for patency by air insufflation (40 mmHg). The microscopic assessment was performed to parameters of damages in epithelium caused by the adhesive, the degree of inflammatory process, morphometry data values of tube diameter (UT) (cm), mucosa thickness (MT) and the myosalpinx thickness (MyT) (mm). The mucosa cells densitometry (total optical density) was expressed by the amount of DNA. The significance of the differences in histological scores and in thickness measurements were made by ANOVA test (P value < 0.05). RESULTS: In all animals of GB: the adhesive was attached to the mucosa; there was no pregnancy; no records of significant degree on inflammatory process; the patency test was negative and densitometry of DNA showed similar values to the both groups independently of observation periods. The layers thickness of GB-UT(1.118±0.117), GB-MT(0.447±0.247) and GB-MyT(0.853±0.097) were larger than the GS-UT(0.666±0.409), GS-MT(0.211±0.070) and GS-MyT(0.442±0.143). CONCLUSION: This approach offers a safe and feasible method of uterine tube obstruction.

Essure®: a new device for hysteroscopic tubal sterilization in an outpatient setting

OBJECTIVE

To evaluate the results of hysteroscopic placement of an intratubal device for permanent birth control in 85 women in an outpatient setting.

DESIGN

Prospective, observational study.

SETTING

Private university hospital.

PATIENT(S)

Eighty-five premenopausal women who asked for tubal sterilization by hysteroscopy between July 2002 and July 2003.

INTERVENTION(S)

Hysteroscopic placement of titanium-dacron intratubal devices in an outpatient setting.

MAIN OUTCOME MEASURE(S)

Procedure feasibility without anesthesia, success rate of device implantation, patient satisfaction, and confirmation of correct placement.

RESULT(S)

Successful placement was achieved in 81 patients (95%). Mean time elapsed between the start of hysteroscopy, placement of devices, and removal of optics was 9 minutes (range, 1-35 minutes). No intraoperative or postoperative complications were detected. Of 81 patients, 75 (93%) had abdominal x-ray performed at the third month; bilateral correct placement was confirmed in all of them.

CONCLUSION(S)

Essure is a safe, effective, and minimally aggressive procedure with satisfactory patient acceptance that does not require anesthesia or hospitalization. It seems to be a good alternative to laparoscopic tubal sterilization.

Diode laser assisted transcervical tubal sterilization: an in vivo study in rabbits

BACKGROUND AND OBJECTIVE

To investigate the sterilization effectiveness of endoluminal tubal photocoagulation on tubal lumen obliteration.

STUDY DESIGN/MATERIALS AND METHODS

Twenty-four female rabbits were subjected to laparotomy and hysterotomy. Endoluminal tubal photocoagulation was induced over a length of 3 cm in the proximal, extramural fallopian tube by using a cylindrical diffusing tip that emitted diode laser radiation at 805 and 980 nm wavelengths. Tubal patency was evaluated by observing patterns of injected methylene blue and/or breeding success rates.

RESULTS

Postoperative recovery was uneventful in all animals. Evidence of occlusion of the tubal lumen included a negative methylene blue test in all 12 tubes treated (tubal occlusion rate 100%) and failure to conceive in 17 of 18 uteri (contraception rate 94.5%). Although identical power settings were used, distinctly lower tubal surface temperatures (about 10 degrees C) were obtained with the 805 nm diode laser as compared to the 980 nm diode laser.

CONCLUSIONS

The described endoluminal tubal photocoagulation method using a diode laser emitting longer wavelengths (e.g., 980 nm) is suitable for safe and effective sterilization in rabbits and has potential as a new transcervical tubal sterilization method for humans.