58345 Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography

Name of the Procedure:

Transcervical Introduction of Fallopian Tube Catheter for Diagnosis and/or Re-establishing Patency (any method), with or without Hysterosalpingography

Summary

This procedure involves inserting a catheter through the cervix into the fallopian tubes to diagnose and/or treat blockages. It may be accompanied by hysterosalpingography, an imaging test to visualize the inside of the uterus and fallopian tubes.

Purpose

The procedure is used to either diagnose blockages in the fallopian tubes or to help reopen blocked tubes, thereby assisting in fertility. It aims to restore the patency of the fallopian tubes and improve the chances of natural conception.

Indications

• Infertility or difficulty conceiving
• Suspected tubal blockages from previous infections, surgeries, or endometriosis
• Recurrent pregnancy loss
• Previous inconclusive imaging results of the fallopian tubes

Preparation

• You might be asked to fast for a few hours before the procedure.
• Inform your doctor about any medications you're taking, as some may need to be adjusted.
• A pregnancy test is usually required to ensure you are not pregnant.
• You may need to have a pre-procedure pelvic exam or ultrasound.

Procedure Description

1. The patient will lie on an examination table with feet in stirrups.
2. A speculum is inserted into the vagina to open it and allow access to the cervix.
3. A catheter is then carefully threaded through the cervix and into the fallopian tubes.
4. If performing hysterosalpingography, a contrast dye is injected through the catheter, and X-rays are taken to visualize the fallopian tubes.
5. In cases of blockage, special tools may be used through the catheter to clear the obstruction.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

It is usually performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Gynecologist or specially trained physician
• Nurses or medical assistants
• Radiologist (if hysterosalpingography is performed)
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Mild to moderate cramping or discomfort
• Infection
• Allergic reaction to contrast dye (if used)
• Perforation of the uterus or fallopian tubes
• Bleeding

Benefits

• Diagnosing the cause of infertility
• Potentially reopening blocked fallopian tubes, increasing the chance of natural conception
• Immediate results from imaging if hysterosalpingography is performed

Recovery

• Mild cramping and spotting for a few days
• Over-the-counter pain relievers may be recommended for discomfort
• Avoid sexual intercourse and tampon use for a few days
• Follow-up appointment to discuss results and next steps

Alternatives

• Laparoscopic surgery for tubal diagnosis and repair
• In vitro fertilization (IVF)
• Hysterosalpingography alone for diagnostic purposes
• Each alternative varies in invasiveness, effectiveness, and cost.

Patient Experience

During the procedure, you might feel some cramping when the catheter is inserted. Post-procedure, expect some mild discomfort and spotting, which can be managed with pain relievers. Follow-ups with your healthcare provider will ensure you are healing well and to discuss any further treatments if necessary.