Interventional minimally invasive treatment of blocked fallopian tubes

  Tubal obstruction accounts for about 1/3 of the causes of female infertility, most of which are non-organic lesions, mostly due to tubal mucus obstruction and membranous adhesions.  Traditional treatment methods: In the past, iodine oil imaging and lavage test were used as the main diagnostic methods for tubal obstruction, but the results were not good, with false positives as high as 30%, and conventional lavage and lavage were prone to spasm of the dilator muscles of the fallopian tubes and painful dilatation of the uterine cavity, and could not increase the extrusion and separation of the tubes by lavage. The degree of patency is roughly estimated by the feeling of pushing and the amount of fluid intake, and it cannot clearly determine the patency or not, especially for the damage of inflammatory mucosa, and it is not effective for distal obstruction. Hysteroscopy is easy to misdiagnose as tubal patency when there is hydrosalpinx or umbilical adhesions, resulting in false negatives, and to obtain false positive results for adhesions and distortions due to peri-tubal inflammation; laparoscopy is a minimally invasive examination, which is complicated and has certain risks.  Interventional procedures: These include Selective Salpingography (SSG) and Fallopian Tube Recanalization (FTR). Interventional procedures have the advantages of being safe, simple, minimally invasive, and repeatable.  Selective tubal angiography can fill the lumen of the fallopian tube with contrast agent and show the details of obstruction clearly and accurately, providing more reliable information about the mucosal wall, lumen and umbilical end of the fallopian tube. At the same time, because selective tubal imaging increases the hydrostatic pressure inside the tube, the flushing of the lumen with contrast agent can more effectively disintegrate the mucus plug and separate the membranous adhesions, which can overcome the resistance of muscle spasm and eliminate the false positive rate of up to 30-40% that occurs in ordinary hysterosalpingography.  If the injection of contrast agent fails to recanalize, the adhesions are heavy and tubal recanalization can be performed immediately. The tubal recanalization can be performed by pushing and expanding the guide wire to separate the dense adhesions in the lumen, which has a good effect on the tubes and is of high value in the diagnosis and treatment of tubal disorders, without the pain caused by tubal spasm and overexpansion of the uterine cavity due to conventional lavage and contrast, and without false negative and false positive results.  Time of surgery: 3-7 days after menstruation Indications: unilateral or bilateral obstruction of the interstitial or isthmus part of the fallopian tubes Contraindications: those with clear obstruction in the abdominal and/or umbilical parts of the tubes; acute onset of inflammation of the reproductive tract; fever; cardiac, hepatic and renal insufficiency; active tuberculosis; iodine allergy; post-anastomotic obstruction.