Indications for cook guide wire interventional recanalization:
1, 3-7 days after menstruation, no infection in the genital or pelvic cavity.
2, Bilateral or unilateral obstruction in the interstitial part, narrow part, and proximal part of the abdomen of the fallopian tube.
3.Conventional hysterosalpingography is feasible because of poor contrast contrast contrast back into the vagina due to too loose cervical opening.
4, Bilateral or unilateral tubal patency, excessive thinness or distortion, mainly using catheter dilation after insertion of drugs through the catheter to reach the lesion to reduce the degree of obstruction.
5. In the peritoneal fluid of endometriosis, a protein that prevents egg picking forms a membrane covering the cilia at the end of the umbilicus, thus affecting pregnancy.
Is hydroperfusion suitable for contrasted tubal passage?
The tubal lavage and lavage is just a simple lavage and is only used as a preliminary screening tool for tubal disease, it is not accurate enough to operate and should not be used as a basis for this. The main reason is the adhesions, narrowing and peristaltic dysfunction of the tubal lumen caused by inflammation. It is possible to recover from the treatment, this is completely treatable don’t worry too much! Treatment: For tubal recanalization, it is necessary to do an outpatient imaging examination to see the specific site of tubal ligation, whether there are adhesions, and to have a clear diagnosis of the function of the tubal before a suitable treatment plan can be formulated according to the specific situation. At present, the imaging department of our hospital adopts “COOK guidewire intervention and recanalization”, which does not need to open an incision, under the visualization of the 0.38 mm U.S. imported platinum guidewire, sent to the tubal obstruction site, through local minimally invasive technology for the treatment of the tubal area, the effect is very significant, the current hospital statistics of the obstruction of the unblocking rate of more than 90%, the pregnancy rate of more than 60% within six months.
U.S. cookie guide wire technology
As early as 1966, it was reported that a metal guidewire was used to perform selective tubal imaging, which then led to numerous studies on the diagnosis and treatment of tubal obstruction via the cervical tube, making the tubal guidewire unblocking a new element in the study of tubal physiology, pathology, diagnosis and treatment. The introduction of the US COOK guidewire system and the use of clinical cases have proved its practicality and superiority. Among female infertility, infertility due to tubal factors accounts for 30% to 50%, among which tubal blockage is the most common cause, and hysterosalpingography is feasible for patients with primary infertility, secondary infertility, reduced menstruation, amenorrhea or IVF.
Since the late 1980s, experts have chosen to use transcervical tubal catheterization in cases of proximal tubal obstruction according to HCG, i.e., to insert a catheter or guidewire or epidural catheter, ureter catheter, or transcervical tubal opening under X-ray fluoroscopy, ultrasound, manual or hysteroscopic application of coaxial system catheter into the proximal “obstructed” part of the fallopian tube. The catheter or guidewire or epidural catheter, ureteral catheter, trans-cervical ureteral opening, is inserted into the proximal “blockage” area of the fallopian tube to pass invisible material and minor luminal adhesions, followed by lavage or direct lavage through the inserted catheter, in order to restore unilateral or bilateral fallopian tube access and achieve conception. The COOK guidewire currently used in the clinic is a catheter placed through the vagina to the opening of the uterus with a 0.038 mm platinum guidewire. Under the direct view of television surveillance and tuboscopy, the doctor unblocks the fallopian tubes through local interventional techniques and places drugs to prevent adhesions, and performs hysterosalpingography on the patient.
In recent years, with the development and application of hysteroscopy and other endoscopes, experts have combined the US COOK guidewire with hysteroscopy and laparoscopy in clinical cases in order to further improve the safety performance of the COOK guidewire and the pregnancy rate of the patient. The COOK guidewire and its cuff are used for the treatment of proximal tubal obstruction under X-ray, avoiding the blindness of intubation, and the operation can be performed under direct vision of the TV screen to achieve more accurate movements and minimize endometrial damage; and the morphology of the uterine cavity and endometrial growth can be routinely examined to exclude or confirm the diagnosis of uterine infertility factors; moreover, because of the super smooth coating on the surface of the guidewire and the blunt and rounded front end, it is not easy to have tubal perforation. Since the procedure is performed under direct vision, complications such as pelvic infection, perforation of the uterus and fallopian tubes, and cervical tearing can be avoided with strict aseptic operation and mastery of hysteroscopic surgical techniques. Although the angled outer casing at the front of the guidewire has an extremely strong torsional control force, which makes intubation easy and simple, and the procedure takes only about 1 hour.
[Advantages
The method is minimally invasive and can be used as the first choice for the recanalization of near-segment tubal obstruction. It is simple, safe and effective, with small trauma, no scars, little pain, quick postoperative recovery, short hospital stay and few complications. It can achieve the dual purpose of diagnosis and treatment, and has been popularized in clinical practice.
However, both doctors and patients still need to strictly grasp the indications and contraindications in the following aspects.
[Indications
1. Selective tubal angioplasty and drug infusion are feasible for all tubal obstructions;
2, Interstitial, isthmus and proximal tubal obstruction are feasible for tubal recanalization;
3. If conventional hysterosalpingography is not completed due to relaxation of the cervical opening, selective hysterosalpingography can be tried with caution.
Contraindications to interventional treatment.
1, Acute inflammation of the reproductive or pelvic cavity.
2. Severe systemic diseases.
3, Obstruction at the distal end of the potbelly and umbilical end is not suitable for recanalization by guidewire.
4.Severe occlusion of the uterine horn, reocclusion after tubal anastomosis and tubal obstruction and tuberculous tubal obstruction should not be performed.