Objective: To study the efficacy of different anti-adhesion agents used in preventing tubal obstruction after recanalization.
Methods: Five hundred and eight patients with tubal obstruction were divided into 245 cases in control group, 108 cases in chitosan group; 113 cases in sodium hyaluronate group and 42 cases in lipiodol group. The patients in control group were injected with anti-inflammation agents after recanalization, while other groups were injected with chitosan, sodium hyaluronate or lipiodol at dose of 2 - 3 ml in every therapeutic group. The rate of location of tubal obstruction and tubal recanalization were recorded during operation. Then patients in every group were followed up on tubal patency after 3 months, and pregnancy rate after 12 months.
Results: Among 1016 fallopian tubes in 508 patients, there were 330 tubes occlusion at isthmus portion and 563 tubes occlusion at interstitial portion of fallopian tube. Thirty-seven fallopian tubes were ablated because of ectopic pregnancy, 86 fallopian tubes were unobstructed. (1) The recanalization rate were 95.7% (179/187) in chitosan group, 97.9% (191/195) in sodium hyaluronate group, 98.7% (75/76) in lipiodol group and 97.7% (425/435) in control group, which did not show statistical difference (P > 0.05). (2) The rates of tubal patency after 3 months of 91.7% (99/108) in chitosan group and 88.5% (100/113) in sodium hyaluronate group were significantly higher than 71.4% (30/42) in lipiodol group and 74.3% (182/245) in control group (P < 0.05). (3) The rates of intrauterine pregnancy after 12 months were 48.1% (52/108) in chitosan group and 41.6% (47/113) in sodium hyaluronate group, which were significantly higher than 23.8% (10/42) in lipiodol group and 24.1% (59/245) in control group (P < 0.05).
Conclusion: Chitosan and sodium hyaluronate could be effective to prevent tubal obstruction after interventional recanalization and increase pregnancy rate.