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Huang C, He X, Luo W, Chen H, Huang Y. Combined chitosan and Dan-shen injection for long-term tubal patency in fallopian tube recanalization for infertility. Drug Deliv Transl Res 2020; 9:738-747. [PMID: 30610502 PMCID: PMC6606764 DOI: 10.1007/s13346-018-00611-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To prospectively study the efficacy of different anti-adhesion agents for the prevention of tubal obstruction after recanalization, this trial was approved by our hospital ethics committee. Four hundred patients with fallopian tube obstruction were randomly assigned to four groups. The control group underwent recanalization alone, whereas the other groups were injected with chitosan, Dan-shen, or combined chitosan and Dan-shen after recanalization. The tubal patency rate in all four groups was recorded after 12 day, 3 months, and 12 months. The pregnancy rates were noted after 12 months. The recanalization rates after 1 day in the control, chitosan, Dan-shen, and combined chitosan and Dan-shen groups were 94.1, 97.1, 96.5, and 98.2%, respectively (p = 0.18, p > 0.05). The rates of tubal patency after 3 months were significantly higher in the combined chitosan and Dan-shen (96.5%), chitosan (88%), and Dan-shen (85.2%) groups compared with the control group (73.9%) (p = 0.0001, p < 0.05). The recanalization rate and intrauterine pregnancy rate after 12 months was significantly higher in the combined chitosan and Dan-shen group (93.8 and 63.9%, respectively) compared with the other groups (control 39 and 30.6%, chitosan 78.4 and 46.9%, and Dan-shen 77.3 and 43.3%) (p = 0.0029 and p = 0.0001, p < 0.05). Chitosan, Dan-shen, or a combination of the two compounds could be effective for preventing tubal obstruction after interventional recanalization, possibly increasing the rate of pregnancy in affected women. The combined chitosan and Dan-shen injection has unique advantages in the interventional recanalization of obstructed fallopian tubes.
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Affiliation(s)
- Chen Huang
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Xueping He
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Wenfeng Luo
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Hanwei Chen
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
- Medical Imaging Institute of Panyu, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
| | - Yi Huang
- Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou, 511400 China
- Department of Radiology, Guangzhou Panyu Central Hospital, 8 East Fuyu Road Qiaonan Street, Panyu District, Guangzhou, 511400 China
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Cohen SB, Bouaziz J, Jakobson-Setton A, Goldenberg M, Schiff E, Orvieto R, Shulman A. Hysteroscopically guided transvaginal ultrasound tubal catheterization-a novel office procedure. Eur J Obstet Gynecol Reprod Biol 2016; 204:113-6. [PMID: 27544744 DOI: 10.1016/j.ejogrb.2016.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/09/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Investigate a novel office hysteroscopic tubal catheterization therapeutic method for proximal tubal occlusion. STUDY DESIGN Prospective cohort study in a tertiary referral center. We evaluated the procedure on a group of 27 patients that were referred to our unit for proximal tubal occlusion demonstrated by hysterosalpingography, 9 (33.3%) of them with primary infertility and 18 of them (66.6%) with secondary infertility. The intervention included the usage of the modified Novy cornual cannulation set which was inserted through a 5F working cannel during an office operative hysteroscopy, followed by fallopian tube irrigation with saline-air mixture under ultrasonographic imaging. RESULTS Our series revealed no complication during or after the procedure; anesthesia was not required. One patient lost from follow-up. Of the remaining 26, 10 patients (38.4%) conceived either spontaneously or with treatment by clomiphene or gonadotropine associated with intrauterine insemination. The median time to conception was 5 months (range 4-17). CONCLUSION We therefore concluded that office hysteroscopic tubal catheterization is a simple (without anesthesia required) option for the treatment of patients suffering from proximal tubal occlusion. Fertility outcomes in our series are comparable to other treatments options for tubal catheterization. Therefore, tubal catheterization should not delay the assisted reproducted techniques if indicated but we propose to include it in a global integrated approach.
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Affiliation(s)
- Shlomo B Cohen
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel.
| | - Jerome Bouaziz
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel
| | - Ariella Jakobson-Setton
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel
| | - Motti Goldenberg
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel
| | - Eyal Schiff
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel
| | - Adrian Shulman
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, and Sackler Faculty of Medicine, Tel-Aviv University, Tel Hashomer 52621, Israel; IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel(2)
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Lazer T, Meltzer S, Saar-Ryss B, Liberty G, Rabinson Y, Friedler S. The place of selective hysterosalpingography and tubal canalization among sub-fertile patients diagnosed with proximal tubal occlusion. Arch Gynecol Obstet 2016; 293:1107-11. [PMID: 26732603 DOI: 10.1007/s00404-015-3998-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/18/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy of selective salpingography and tubal canalization (TC) procedure among patients diagnosed with proximal tubal occlusion (PTO). METHODS We conducted a retrospective cohort study on 61 sub-fertile patients aged 32.6 ± 4.9 years that were referred between the years of 2011 and 2013 with the diagnosis of PTO by prior hysterosalpingography. Patients underwent TC and were classified as bilateral PTO or unilateral PTO. Information regarding the patient's reproductive outcome within the 12 months following the procedure was collected by a telephone survey. RESULTS During the study period, 58/61 (95 %) patients underwent TC, resulting in bilateral open tubes in 54 patients (93.1 %). 53/58 (91.3 %) patients answered our survey. There were 23/53 (43.4 %) patients with a successful procedure who conceived after spontaneous or COH + IUI resulting in 15/23 live births (65.2 %). CONCLUSION Tubal canalization is a safe and minimally invasive procedure that can be used effectively to restore patency in a proportion of cases of PTO thus avoiding the need for expensive and invasive procedures such as assisted reproductive techniques.
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Affiliation(s)
- T Lazer
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - S Meltzer
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - B Saar-Ryss
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - G Liberty
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Rabinson
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - S Friedler
- Infertility and IVF Unit, Barzilai Medical Center, Ashkelon, Faculty of Medicine and Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Schemoul G, Silvera S, Augui J, Legman P, Vignaux O. [Radiologically-guided hysterosalpingography and tubal catheterization]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2007; 35:55-9. [PMID: 17188546 DOI: 10.1016/j.gyobfe.2006.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Accepted: 10/18/2006] [Indexed: 05/13/2023]
Abstract
Radiological exploration of hypofertility by means of hysterosalpingography is a method still valid but no longer sufficient. Tubal catheterization has thus become a necessary complementary exam in order to eliminate the pseudo-obturations of hysterosalpingography and, in case of proximal tubal obstructions, to obtain pregnancies. The conditions for the realization of hysteroalpingography and tubal catheterization are hereby described, with emphasis on the rigorous technique that is required together with careful listening to the patients.
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Affiliation(s)
- G Schemoul
- Hôpital privé Armand-Brillard, 94130 Nogent-sur-Marne, France.
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