Selective Salpingography and Fallopian Tube Recanalization
Lindsay Machan
Indications
1. Clarification of poor filling of fallopian tube on hysterosalpingogram (HSG)
a. Technically inadequate HSG
b. Tubal spasm
c. True obstruction
d. Tubal disorder such as salpingitis isthmica nodosa (SIN)
2. Discordance between HSG and laparoscopy
3. Discordance between HSG and clinical diagnosis
4. Patient not pregnant after surgical anastomosis
5. Prior to fluoroscopic-guided insertion of tubal occlusion device (3)
6. Proximal tubal obstruction for recanalization
Contraindications
Absolute
1. Active pelvic infection
Relative
1. Severe tubal or peritubal pathology not amenable to laparoscopic or surgical repair
2. Distal tubal occlusion (may be performed in conjunction with laparoscopic repair distal tube)
3. Intrauterine adhesions (severe)
4. Anaphylactoid reactions to radiographic contrast media (consider using gadolinium)
Preprocedure Preparation
Pretreatment Assessment
1. Evaluation by infertility specialist or gynecologist including verification of unprotected intercourse for at least 6 months
2. Pelvic ultrasound and laparoscopy optional
3. HSG (can be at the same session)
Patient Education
