A system for simultaneous bilateral tubal cannulation.

Objective: The efficacy of a new system for simultaneous bilateral tubal cannulation under tactile impression was evaluated.

Methods: Two radiologically detectable selective salpingography catheters (Bard Gynecology and Urology, Covington, GA) were glued back to back in a "T" configuration similar to an intrauterine device. A sliding plastic sleeve contained the straightened catheters and the uterus was cannulated under tactile impression. The sleeve was then withdrawn and the catheters opened within the uterine cavity and wedged into the right and left tubal ostia simultaneously. Selective injection of water-soluble radiologic contrast material into the tubes resulted in selective salpingography and determined successful tubal cannulation. Withdrawal of the catheters back into the sleeve allowed injection of contrast material into the uterine cavity.

Patients: The system was evaluated in 14 consenting patients scheduled for hysterosalpingogram during infertility evaluation.

Results: Bilateral selective salpingography was achieved successfully under tactile impression in 12/14 (86%) patients. In two patients with either distorted or very small uterine cavity, the catheter tips embedded into the lateral uterine walls and did not selectively cannulate the tubal ostia. Reapplication of the system under fluoroscopy allowed bilateral selective salpingography of these two patients.

Conclusion: Simultaneous bilateral selective salpingography eliminated the need for cervical cannula, significantly reduced fluoroscopy time to seconds, and demonstrated that tactile cannulation is successful in normal uteri. Application of this system for simultaneous tubal cannulation is identical to intratubal uterine device insertion, a procedure familiar to all gynecologists. Therefore, this catheter system may further contribute to simplification of transcervical access into the fallopian tubes for diagnosis and treatment.