Falloposcopic evaluation for tubal function

Falloposcopic tuboplasty (FT) system has been recently developed for observation of tubal lumen and simultaneously for the treatment of tubal occlusion. The linear eversion catheter guids safely falloposcope by approaching from uterine side. As a result, multiple occlusions have been observed in at least half cases of tubal occlusion. The case of intramural occlusion has been seen in 75.9% of the pregnancy cases following FT treatment. Occlusive preoperative HSG was occupied mostly by proximal portion in pregnancy cases. Although preoperative HSG could afford to confirm only most proximal occlusion part, the case that existence of hydorsalpinx due to ampullar adhesion was recognized after having recovery of tubal patency of proximal occlusion by FT treatment was not a few. Majority of the cases had occlusions in similar portion in bilateral tubes. The incidence of Chlamydia infection which was serological positive, was 35.8% (68/190) in patients with occlusion in bilateral tubes. The rate of tubal patency recovered tended to be lower in the patients of serological Chlamydia positive than those of negative, but the significant difference was not recognized. But, in the cases with high value of Chlamydia antibody, outer adhesion of fallopian tubes such as perifimbrial adhesion or peritubal adhesion existed frequently in addition to the adhesions in tubal lumen. It is shown that observation of not either but both inside and outside is important to evaluate tubal function. In the information that can be checked by falloposcope, color, structure (in each part of fallopian tubes), adhesion, and hydrosalpinx become a helpful information to decide the treatment plan. By falloposcopic observation (1) adhesion scar, (2) fibrous adhesion, (3) hypovascularity, (4) thinning or flattering of tubal fold were seen as major pathological conditions of tubal lumen. Since FT treatment was repeatedly performed for the cases produced reocclusion, reepithelization was seen in the part that patency was recovered by the first time FT, and the findings of tubal lumen were improved.