The use of saline–air as contrast media can be used reliably under ultrasound guidance to document fallopian tube patency. According to researchers as the University of South Florida in Tampa, it also can be done as an office procedure. They reported the results of their study at the American College of Obstetricians and Gynecologists' 58th Annual Clinical Meeting in San Francisco.Noting that previous attempts had demonstrated utility but were limited by the method of generating saline–air contrast and inability to selectively evaluate each tube, Anna K. Parsons, MD, and colleagues last year evaluated 15 patients using a recently FDA-approved proprietary device.
The 11.5F sheath, containing a balloon catheter, was placed transcervically to the fundus after sounding. The 4.5F catheter was advanced from the sheath, where the balloon was placed in the targeted cornu and location was confirmed using ultrasonography. The contrast device attached to the catheter, delivered a consistent sterile saline–air mixture, which was visualized with ultrasonography entering into the cornual–tubal junction. Patency determination was conclusive with evident flow within or exiting the tube or both.
According to the University of South Florida investigators, of the 15 patients, two discontinued because of discomfort from suspected PID. Of the 26 tubes assessed, 25 were determined to be patent as evidenced by contrast travel in the tube or exiting the tube or both. One tube had cornual fill with contrast localized but no travel noted into or out of the tube and notable discomfort during filling, indicative of tubal blockage.
Dr. Parsons and colleagues concluded that “Evaluation of fallopian tube patency using office ultrasonography is a significant advancement, eliminating exposure to radiation and radiopaque contrast. Delivery of consistent saline– air contrast media to evaluate one targeted tube at a time resulted in repeatable patency determination using office transvaginal ultrasonography.”