Selective salpingography (SSG: Selective salpingography)
Tubal recanalization (FTR: Fallopian tube recanalization)
I. Indications
1, Fallopian tube is open but under, open but poor or extremely poor and requires treatment.
2, The fallopian tube is not visualized or partially visualized in HSG, in order to distinguish between tubal spasm or high tension obstruction.
3.HSG shows obstruction in the proximal part of the fallopian tube, to distinguish whether the obstruction is completed by adhesions, or whether the obstruction is loosened by adhesions or more secretions, which can be treated by recanalization.
Contraindications
1.Obvious tubal effusion with obvious wrapping of the umbilical end
2.Tuberculous tubal obstruction
3.Acute or subacute inflammation of internal genital organs, pelvic inflammatory disease, vaginitis
4. Systemic fever of 37.5℃ or more
5.During vaginal bleeding
6.After normal menstruation after curettage
Appointment registration and preoperative preparation are the same as HSG.
IV. Operation procedure
1.Prepare the SSG catheter and outer cuff, guidewire, and the required contrast agent and related drugs.
2.Preoperative pelvic radiograph and intramuscular injection of 654-2 or atropine.
3.Routine disinfection and spreading of towels.
4.Checking the position and size of the uterus and bilateral adnexal pressure for pain by double consultation.
5, dilate the vagina with dilators and disinfect the vagina and cervix.
6.Pulling the cervix with cervical forceps and probing the depth and direction of the uterine cavity with a probe.
7.Insert the catheter into the cuff, place the cuff in the endocervical canal, and then gently feed the catheter into the opening of the fallopian tube (under fluoroscopy).
8. inject contrast under fluoroscopy, take a second film after the fallopian tube is visualized, then inject the treatment solution, and then observe whether there is any residue in the fallopian tube and the contrast diffuses into the pelvis.
9. If SSG shows obstruction in the proximal part of the fallopian tube, insert a guidewire into the internal catheter up to the mouth of the fallopian tube and gently advance the guidewire under fluoroscopy, stop when there is obvious resistance or pain in the patient, and then inject the contrast agent to show the recanalization of the fallopian tube.
10. Observe closely for surgical reactions during the operation and deal with them promptly.