TY - JOUR
T1 - Pressure dynamics in the non-gravid uterus
T2 - intrauterine pressure cannot confirm tubal occlusion after non-surgical permanent contraception
AU - Patil, Eva
AU - Thurmond, Amy
AU - Edelman, Alison
AU - Fu, Rongwei
AU - Lambert, William
AU - Seguin, Jacqueline
AU - Jensen, Jeffrey T.
N1 - Funding Information:
Financial support: This research was supported by the Society of Family Planning Research Fund (SFPRF15-9). However, the views and opinions expressed are those of the authors and do not necessarily represent the views and opinions of the Society of Family Planning Research Fund. The Endocrine Technologies Support Core at the Oregon National Primate Research Center (ONPRC) is supported by National Institutes of Health grant P51 OD011092 awarded to ONPRC.
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/11
Y1 - 2017/11
N2 - Objective The objective was to determine if intrauterine pressure can distinguish bilateral tubal occlusion (BTO) from unilateral or bilateral tubal patency (TP) in women following a permanent contraception procedure. Study design We used a small inline pressure sensor to continuously monitor intrauterine pressure during hysterosalpingogram (HSG) in a cross-sectional study that enrolled women having HSGs for any indication. The primary outcome was the peak intrauterine pressure compared between women with BTO and TP as verified by HSG. Results We enrolled 150 subjects, of which 111 (74.0%) provided usable pressure readings. Of these, 98/111 (88.3%) had TP, and 13 (11.7%) had BTO. There was no difference in peak intrauterine pressure for subjects with TP (mean 293.8±58.7 mmHg) compared to those with BTO (292.7±71.3 mmHg, p=.95). Among parous women, peak intrauterine pressure in subjects with BTO (311.9±78.0 mmHg) was higher but not significantly different from subjects with TP (282.7±49.2 mmHg, p=.20). In linear regression analysis, peak intrauterine pressure was not associated with age, body mass index, gravidity or having at least one prior live birth. Conclusions Measurement of peak intrauterine pressure does not distinguish between women with patent and blocked fallopian tubes. This approach would not be clinically useful to verify occlusion following permanent contraception. Implications Peak intrauterine pressure does not differ between women with patent and occluded fallopian tubes and cannot be used to confirm tubal occlusion after nonsurgical permanent contraception.
AB - Objective The objective was to determine if intrauterine pressure can distinguish bilateral tubal occlusion (BTO) from unilateral or bilateral tubal patency (TP) in women following a permanent contraception procedure. Study design We used a small inline pressure sensor to continuously monitor intrauterine pressure during hysterosalpingogram (HSG) in a cross-sectional study that enrolled women having HSGs for any indication. The primary outcome was the peak intrauterine pressure compared between women with BTO and TP as verified by HSG. Results We enrolled 150 subjects, of which 111 (74.0%) provided usable pressure readings. Of these, 98/111 (88.3%) had TP, and 13 (11.7%) had BTO. There was no difference in peak intrauterine pressure for subjects with TP (mean 293.8±58.7 mmHg) compared to those with BTO (292.7±71.3 mmHg, p=.95). Among parous women, peak intrauterine pressure in subjects with BTO (311.9±78.0 mmHg) was higher but not significantly different from subjects with TP (282.7±49.2 mmHg, p=.20). In linear regression analysis, peak intrauterine pressure was not associated with age, body mass index, gravidity or having at least one prior live birth. Conclusions Measurement of peak intrauterine pressure does not distinguish between women with patent and blocked fallopian tubes. This approach would not be clinically useful to verify occlusion following permanent contraception. Implications Peak intrauterine pressure does not differ between women with patent and occluded fallopian tubes and cannot be used to confirm tubal occlusion after nonsurgical permanent contraception.
KW - Intrauterine pressure
KW - Nonsurgical permanent contraception
KW - Sterilization
KW - Tubal occlusion verification
UR - http://www.scopus.com/inward/record.url?scp=85023608624&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85023608624&partnerID=8YFLogxK
U2 - 10.1016/j.contraception.2017.06.013
DO - 10.1016/j.contraception.2017.06.013
M3 - Article
C2 - 28687179
AN - SCOPUS:85023608624
SN - 0010-7824
VL - 96
SP - 330
EP - 335
JO - Contraception
JF - Contraception
IS - 5
ER -