Characterization of tubal occlusion after transcervical polidocanol foam (PF) infusion in baboons.

OBJECTIVE: Our long-term goal is to develop a nonsurgical method of fallopian tubal occlusion for the purpose of permanent contraception. We have previously demonstrated that transcervical administration of 5% polidocanol foam (PF) can create tubal occlusion in macaques but that multiple treatments are required. In this study, we assessed the efficacy of various regimens of PF with and without depomedroxyprogesterone acetate (DMPA) (to control ovarian cycle phase) in the baboon. STUDY DESIGN: Adult cycling female baboons were evaluated for tubal patency by hysterosalpingography and then received a transcervical infusion of PF with (+) or without (-) an intramuscular injection of DMPA (3.5 mg/kg). Two concentrations of PF were compared: 1% [(+) DMPA, n=5; (-) DMPA, n=3] and 5% [(+) DMPA, n=4; (-) DMPA, n=3]. Controls received (+) DMPA (n=2) or (-) DMPA, (n=3) only. The reproductive tracts were removed 1-3 months after treatment for examination. RESULTS: No fallopian tubal occlusion was observed in negative controls (±DMPA). Histologic complete tubal occlusion was observed in 3/8 of females treated with 1% PF and in 6/7 treated with 5% PF. Histologic evaluation suggested that 1% PF is associated with prolonged chronic inflammation (more than 2-3 months), while 5% treatment eliminates the epithelial lining, at least focally, and resolves into complete occlusion within 1-2 months. This pattern of complete occlusion was seen in all 4 females that received 5% PF (+DMPA) and in 2/3 that received 5% PF (-DMPA). CONCLUSION: In a baboon model of transcervical permanent contraception, a single treatment with 5% PF resulted in complete tubal occlusion more reliably (85%) than 1% PF (38%). Cotreatment with DMPA may improve treatment results with 5% PF but requires additional study. IMPLICATIONS: A finding that a single transcervical treatment with 5% PF can occlude the fallopian tubes of baboon supports further study of this approach as a novel strategy for permanent contraception for women.

[THE ROLE OF NO AND MEXIDOL IN CONTRACTILITY OF OVARIAN AND CERVICAL PARTS OF UTERUS UNDER THE CONDITION OF IMMUNE-MEDIATED INJURY IN MICE].

Contractility of ovarian (OP) and cervical parts (CP) of uterus under the condition of immune-mediated injury which was induced by immunization with bovine serum albumin (BSA) was investigated. It was shown that under the activation of energy-synthesizing function of mitochondria with Mexidol the frequency of reductions in both uterine parts decreased, the amplitude and contractility index in the OP and CP as well as the duration of the active state in CP increased. Mexidol under the condition of immunization with BSA leads to the decrease in amplitude in 2,6 time and contractility index in 2,2 time in OP and to the increase of them in CP. It was shown that contractility features of ovarian and cervical parts of uterine under the condition of BSA- induced immunization were caused by changes of mitochondria functional state and were associated with nitric oxide.

Tubal sterilization by means of selective catheterization: comparison of a hydrogel and a collagen glue.

PURPOSE: To test, in an animal model, two potentially suitable materials for nonsurgical selective tubal sterilization. MATERIALS AND METHODS: A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed in four rabbit fallopian tubes, and a proprietary collagen glue was placed into three rabbit fallopian tubes by means of transvaginal fluoroscopic fallopian tube catheterization. As controls, 11 tubes were catheterized without sterilization material injection. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. Histologic analysis was performed. RESULTS: The short-term contraception rate was 100% in the hydrogel group, 33% in the collagen glue group, and 0% in the control group (P < .001 hydrogel group, P not significant in collagen group). Inflammation was minimal in the three groups (P not significant). CONCLUSION: The collagen glue had an insufficient contraceptive effect and should be abandoned. The hydrogel used proved effective and biocompatible, and long-term studies of this compound are warranted.

PIP: The purpose of this study was to test, in an animal model, two potentially suitable materials for nonsurgical selective tubal sterilization. A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed in four rabbit fallopian tubes, and a proprietary collagen glue was placed into three rabbit fallopian tubes by means of transvaginal fluoroscopic fallopian tube catheterization. As controls, 11 tubes were catheterized without sterilization material injection. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. Histologic analysis was performed. The short-term contraception rate was 100% in the hydrogel group, 33% in the collagen glue group, and 0% in the control group (P .001 hydrogel group, P not significant in collagen group). Inflammation was minimal in the three groups (P not significant). The collagen glue had an insufficient contraceptive effect and should be abandoned. The hydrogel used proved effective and biocompatible, and long-term studies of this compound are warranted.

Selective tubal sterilization in rabbits: experience with a hydrogel combined with a sclerosing agent.

PURPOSE: To test a method of nonsurgical sterilization. MATERIALS AND METHODS: A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed into fallopian tubes of eight rabbits by means of transvaginal rabbits by means of transvaginal fluoroscopic fallopian tube catheterization. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. RESULTS: Seven of the eight rabbits became pregnant. Six of these rabbits contained embryos in the control uterus but not in the uterus on the side of the hydrogel injection. The seventh rabbit had embryos in both uteri, but the hydrogel had been expelled. All seven tubes that contained hydrogel showed evidence of acute and chronic salpingitis and a foreign-body reaction. The tube from which hydrogel had been expelled and the eight control tubes were not inflamed. CONCLUSION: Transcervical catheter methods of tubal occlusion and sterilization are promising, but a non-reactive material is needed.

[Effects of Ilexonin A on chemical salpingitis induced tubal obstruction in rats].

Ilexonin A, a new drug in improving the blood circulation and microcirculation, is extracted from Ilicis pubescentis. The preventive and therapeutic effects of Ilexonin A on chemical salpingitis induced tubal obstruction (CSTO) with morphological and hemorheological change in rats was studied. Results showed that Ilexonin A was effective in treating (CSTO by oppositing the degeneration and necrosis of epithelium, inhibiting the hyperplasia of connective tissue, and reducing the infiltration of inflammatory cells. The improvement of morphology was more significant in treated groups than that in controls (P < 0.05-0.01). The indices concerning model rat's hemorheology were also analysed between treated groups and controls. It indicated that Ilexonin A could improve the viscosity of blood and aggregation of red blood cells. It is suggested Ilexonin A could promote the absorption of inflammatory substances as a result of improving hemorheology.

Selective injection of contrast media: inflammatory effects on rabbit fallopian tubes.

The inflammatory effects of fallopian tube catheterization and selective injection of seven contrast agents (ethiodized oil, diatrizoate meglumine 52%, diatrizoate meglumine 66%, iothalamate meglumine 60%, iopamidol, ioxitol, and ioxaglate) were evaluated in 88 rabbits. The contrast agent used was randomly selected and selectively injected after unilateral catheterization; the contralateral side was used for control. Pathologic inspection of right and left uteri with attached fallopian tubes and ovaries was done without knowledge of side of catheterization or duration of time since catheterization. The degree and location of inflammation were noted. Inflammation disappeared by 4 days in five of seven contrast agents. Iothalamate meglumine 60% and iopamidol required 2 weeks for disappearance of inflammation. Essentially no inflammation was associated at any time with ioxaglate. These findings suggest that all of these contrast agents would be clinically acceptable for direct injection into the human fallopian tube.

Late effects of embryonic allylestrenol treatment in chicken.

Allylestrenol when applied to chick embryos on the 9th day of incubation or on the 9th day of incubation and at hatching brought about a severe purulent inflammation of the oviduct at 6 weeks of age in 50% of the animals. Treatment at hatching only had no effect whatsoever. The findings suggest that allylestrenol must be applied with caution during pregnancy.

[Early inflammatory complications in induction of abortion by means of intrauterine extra-amnial administration of prostaglandin F 2 alpha in primigravidae]. / Entzündliche Frühkomplikationen bei der Abortinduktion durch intrauterine extraamniale Applikation von Prostaglandin F 2 alpha bei Erstgraviden.

PIP: Prostaglandin F2 alpha was used to induce abortion in 287 primigravidae, aged 13-44 (average age 17.5), who were 6-12 weeks pregnant. A solution of 5 mg prostaglandin to 20 ml isotonic salt solution was instilled extraamnially in 3 ml dosages at 1 hour intervals. If more than 8 instillations were required, the dosage was increased to 4-6 ml. In 61.3% of the patients, incomplete abortion was observed. In 30.3%, an additional minor Hegar dilatation was necessary. In 6.3%, complete Hegar dilatation was easily performed. The failure rate was 2.1%. There were 3 cases of endometritis, 9 of salpingitis, and 11 of adnexitis. The average postoperative hospitalization period was 6.7 days.^ieng