Method For Resolution Of Promixal Tubal Obstruction During Hysterosalpingography

Objective: To study the methods for resolution of the promixal tubal obstructions during hysterosalpingography and to evaluate and detect the characters of proximal tubal obstruction during hysterosalpingography.Methods: 338 women with infertility from the center for reproductive medicine, were divided into 4 groups randomly: group A, B, C and D. Group A, 95 women with 184 tubes, were performed conventional hysterosalpingography. Patients in group C and D, including 86 women with 169 tubes seperately, were subjected to injecting 10mg of 654-2 about 10 to 30 minutes before hysterosalpingography, in group B and D, promixal tubal "obstructions" during hysterosalpingography were observed, and then the patiens were rotated approximately 45° to left or right oblique position and the procedure was continued. Then 180 women randomly were selected from 338 women again and divided into 3 groups again: groupD₁, D₂, D₃, they were employed seperately with different contrast medium that was Iopamido 300, Ioversol 320, Iopromide 370 and by the same method as group D.Results: The proportion of obstruction in group A, B, C and D was 32.07%, 15.83%, 14.20%, 7.10% respectively. Proximal tubal obstruction with sharp angle in group A existed excessively, so were those with filling defect in three other groups. Unilateral tubal obstructions in four groups were seen more usually than the bilateral. The effects of three non-ionic contrast media were similar in hysterosalpingography.Conclusions: By intramuscular injection with 654-2 and patient' s rotations, resolution of promixal tubal obstruction could be found during the hysterosalpingography. The rate of promixal tubal obstructions is more than the one of the distal.