Hysteroscopic Tubal Occlusion with the use of Iso-Amyl-2-Cyanoacrylate

Objective: To assess the safety and effectiveness of using Iso-Amyl-2-cyanoacrylate for hysteroscopic tubal occlusion in women.

Methods: It is a pilot study on 25 patients with benign uterine lesions indicates hysterectomy. Hysteroscopy tubal injection of 0.5 ml Iso-amyl-2-cyanoacrylate was done in one tube of each patient and the other tube was used as a control. The Patients were then randomly scheduled for total abdominal hysterectomy and bilateral salpingoophorectomy into 5 equal groups: Group 1 was scheduled first day post hysteroscopy, Group 2 after one week, Group 3 after 2 weeks, group 4 after 3 weeks and group 5 after 4 weeks. Methylene blue test on the hysterectomy samples for tubal patency and histopathology for severity of tissue reaction was done. Categorical variables were presented as number and percentage and intergroup differences were compared using Fisher’s exact test. P-value <0.05 was considered statistically significant.

Results: Tubal chronic nonspecific inflammation was noted in all cases and perisalpingitis was noted in two cases (8%). Twenty cases out of 25 had a negative methylene blue test representing an 80% success rate for tubal occlusion. All cases were occluded in Group 1, in groups 2, 3 and 4 each had four cases (80%) and group 5 had three cases (60%) with tubal occlusion, without statistically significant difference between the five groups.

Conclusion: Iso-amyl-2-cyanoacrylate for hysteroscopy tubal occlusion is safe, while evaluation of its effectiveness for sterilization will still require a larger sample size and a longer period of follow up.

Keywords: Fallopian tube, hysteroscopy, Isoamyl-2-cyanoacrylate.