Salpingoscopic evaluation of tubal mucosa in cases of infertile women with unilateral or bilateral proximal tubal obstruction

ملخص انجليزى صفحة واحدةIt is considred that one out of five couples present a transitory problem of infertility during their reproductive life and the most frequent cause is the tubal pathology, from these, the proximal obstruction occupies between 25 and 30 % of the cases. The conventional methods used to study tubal patency such as hysterosalpingography or the direct observation by laparoscopy and selective chromotubation , frequently do not allow to differentiate between an insufficient filling of the tube , tubal spasm or true mechanical obstruction. (Salazar et. al. 1999).Combined laparoscopy and hysteroscopy brings a lot of information concerning the structure and function of the oviductus. (Wilczak et. al 1994)Salpingoscopy, is a transfimbrial approach. Allowing visualization of the tubal lumen endoscopically from the ampullary- isthmic jumction to the fimbriae. It may be performed without general anaesthesia. The procedure provides more sensitive information than laparoscopy with chromotubation or hvsterosalpingography alone. With more widespread acceptance, endoseopic evaluation of the fallopian tube may become a standard component of the infertility evaluation . (Surrey -et. al. 1999)Tubal patency rates after transcervical cannulation have been reported to be from 30% to 75% (Hershlage et al, 1990, and Mailarini et al., 1992). These vary depending on whether reported pregnancy rates include pregnant patients or are reported as a percentage of nonpregnant patients who underwent a follow-up study. The results of (Das et al., 1995) suggest that tubal patency rates at 1 year in nonpregnant patients were higher in patients who had resection anastomosis compared with hysteroscopic tubal cannulation. If pregnancy is not achieved within 6 months, intralurninal obstruction may reform earlier with time after hysteroscopic tubal cannulation.