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Fallopian Tube Catheterization Recanalization Introduction Fallopian tube catheterization, also known as recanalization, is a procedure to help clear a blockage in the Fallopian tubes. A blockage in a Fallopian tube is a common cause of female infertility. Infertility means that a woman is unable to get or stay pregnant. This reference summary explains Fallopian tube catheterization. It covers the anatomy of the female reproductive system. It also discusses what to expect before, during and after the catheterization procedure. The Female Reproductive System The female reproductive organs are located in the pelvis, between the urinary bladder and the rectum. Ovaries The female reproductive organs include: • The ovaries. • The Fallopian tubes. • The uterus. • The cervix. • The vagina. Fallopian Tubes Uterus When an ovary releases an egg, the Cervix egg goes down the Fallopian tube to the uterus. Fertilization usually Vagina takes place inside the Fallopian tube. The sperm must swim through the vagina and cervix, into the uterus and up into the Fallopian tube. The sperm fertilizes the egg. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 1 The fertilized egg, called an embryo, then travels to the uterus. It stays and grows in the uterus until delivery. The cervix is the narrow, lowest part of the uterus. It is a passageway that connects the uterus to the vagina. The vagina opens to the outside of the body between the urethra, which is the urinary bladder opening, and the rectum. Fallopian Tube Catheterization If there is a blockage in the Fallopian tubes, it may cause infertility in women. About 25% of women who have difficulty getting pregnant have a blockage in one or both of their Fallopian tubes. A Fallopian tube blockage usually is caused by a buildup of scar tissue. This may be caused by: • Certain medical conditions, such as pelvic inflammatory disease. • Endometriosis. • Previous ectopic pregnancy. Scarring from surgery can also lead to a blockage. Fallopian tube catheterization is a nonsurgical procedure to clear blockages. No incisions, or cuts, are made. No needles are used. The procedure may also help your health care provider diagnose the cause of the blockage. Fallopian tube catheterization may be less costly than other fertility procedures. Alternative Treatments There are several treatment options that can reopen the Fallopian tubes and remove blockages, including: • Salpingectomy. • Salpingostomy. Salpingectomy is the surgical removal of the part of the Fallopian tube that is blocked, leaving the rest of the tube open. Salpingostomy is the surgical creation of a new opening in the Fallopian tube entrance closest to the ovary. The results of the procedure are usually temporary. Scar tissue often reforms and causes another blockage within 3 to 6 months. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 2 The Procedure Fallopian tube catheterization is done shortly after your menstrual period ends. This is to make sure that you are not pregnant while the procedure is done. Your health care provider will prescribe an antibiotic to be taken before the procedure. Do not eat anything after midnight the night before the procedure. Fallopian tube catheterization takes about half an hour. You will be able to leave the health care facility about half an hour after the procedure is done. Someone else should drive you home. During Fallopian tube catheterization, you will lie on your back on an x-ray table. An IV will be placed in your arm or hand to deliver medications. Your health care provider will place a speculum into the vagina to open it. A speculum is a metal or plastic device that is used to dilate a canal in the body. Dilate means to make something larger, wider or more open. A catheter is a small plastic tube. It is passed through the vagina and through the cervix into the uterus. The catheter is injected with a liquid contrast agent, or dye. Your health care provider will use x-rays to view an image of your uterus and Fallopian tubes. This image is known as a hystero-salpingogram, or HSG. Your health care provider may find a blockage in one or both of your Fallopian tubes. If a blockage is found, your health care provider may perform a tubal cannulation. A smaller catheter will be threaded through the first catheter. It will pass through the Fallopian tube and open the blockage. In more than 90% of all cases, at least one blocked Fallopian tube can be reopened. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 3 Risks and Complications Fallopian tube catheterization is safe. But there are possible risks and complications. These are not likely. But they are possible. You need to know about them just in case they happen. By being informed, you may be able to help your health care provider detect complications early. Your health care provider may recommend that anesthesia be used. Most healthy people do not have any problems with anesthesia. Some people have mild, temporary side effects. But anesthesia is safe. Risks of anesthesia include: • Headache. • Nausea. • Vomiting. Complications of anesthesia are rare. They are more likely to happen in older adults or people with serious medical problems compared to younger, healthy patients. Complications can include: • Temporary mental confusion. • Lung infections. • Stroke. • Heart attack. • Death. Fallopian tube catheterization may not be right for you if you have: • A lot of scarring in the Fallopian tubes. • Tubes that are severely damaged. Fallopian tube catheterization may not be right for you if you have: • A severe blockage that a catheter is unable to pass through. • A blockage in a part of the tube that is far from the uterus. • A blockage in the isthmus, the narrowest part of the Fallopian tube. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 4 The procedure may not restore tube function or allow pregnancy to happen. Other possible complications of Fallopian tube catheterization include: • Tearing of the Fallopian tube wall. • Peritonitis. • Pelvic infection. Peritonitis is a life-threatening infection. It affects the tissue covering the abdominal organs. Other possible complications of Fallopian tube catheterization include: • Exposure of the reproductive organs to radiation. • Tubal pregnancy. A tubal pregnancy happens when a fetus develops in a Fallopian tube instead of the uterus. The fertilized egg cannot survive. After the Procedure Do not have sex for 48 hours after Fallopian tube catheterization. Do not put anything into your vagina, such as a tampon. Do not douche. Many women have mild cramps and spotting for a day or 2 after the procedure. This is normal. You can try to get pregnant once the spotting has stopped. About 25% of women become pregnant within a few cycles after their tubes are unblocked. Contact your health care provider right away if you experience: • Severe cramps, pain or bleeding. • Fever. • Vaginal discharge. The procedure may unblock the tubes. But it does not reverse the process that caused them to be clogged in the first place. About one third of patients will have blockages in their tubes again in about 6 months. Tell your health care provider if you have not gotten pregnant after trying for 6 months. He or she may perform another HSG to find any new blockages and open them. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 5 Reopening the Fallopian tubes may not help a woman get pregnant. But other treatments are available. Talk to your health care provider about the options that are right for you. Summary The Fallopian tubes are part of the female reproductive system. They are slender tubes through which eggs pass from an ovary to the uterus. There is one ovary and one Fallopian tube on each side of the uterus. A blockage in a Fallopian tube is a common cause of female infertility. Infertility means that a woman is unable to get or stay pregnant. Fallopian tube catheterization, also known as recanalization, is a procedure to help clear a blockage in the Fallopian tubes. Fallopian tube catheterization takes about half an hour. You will be able to leave the health care facility about half an hour after the procedure is done. Someone else should drive you home. Your health care provider may find a blockage in one or both of your Fallopian tubes. If a blockage is found, your health care provider will perform a tubal cannulation. A smaller catheter will be threaded through the first catheter. It will pass through the Fallopian tube and open the blockage. In more than 90% of all cases, at least one blocked Fallopian tube can be reopened. The opened tube will function normally. The procedure may unblock the tubes. But it does not reverse the process that caused them to be clogged in the first place. About one third of patients will have blockages in their tubes again in about 6 months. Reopening the Fallopian tubes may not help a woman get pregnant. But other treatments are available. Talk to your health care provider about the options that are right for you. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2017, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/25/2017 og990101 6