Falloposcopic comparison of unilateral and bilateral proximal tubal occlusive disease.

The purpose of this study was to compare the appearance of the entire length of the oviductal canal in women with unilateral versus bilateral proximal tubal occlusion. Eleven women had apparent unilateral disease and 18 had apparent bilateral occlusion. Proximal occlusion was confirmed both by hysterosalpingography and laparoscopy. Falloposcopic examination was performed by retrograde visualization using the linear eversion catheter, in office. Bilateral apparent proximal occlusion was found to have a significantly higher incidence of actual proximal occlusion and distal intralumenal abnormalities. However, five proximal segments and six distal segments were found to be abnormal where the pre-examination diagnosis was unilateral occlusion. Furthermore, the contralateral oviductal canal was found to be abnormal in four women with apparent unilateral disease, indicating that apparent unilateral proximal tubal occlusion is associated with actual pathology. These data demonstrate the value of intralumenal assessment of apparent proximal occlusion.