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Sterilization with fibrin sealant in a rabbit uterine horn model

      Abstract

      Objective: This study investigated the effects of a fibrin sealant with or without coagulation in obliterating the tubal lumen at the uterotubal junction in rabbits. Study design: Twenty-three female rabbits were subjected to aparotomy and hysterotomy. They were randomly divided into four groups, and the fallopian tubes underwent different treatment: In group 1 (n = 14) both bipolar coagulation and the fibrin sealant were used. In group 2 (n =10) only fibrin sealant without coagulation was used. In group 3 (n = 11) only coagulation was used. In group 4 (n = 10) no treatment was performed (control group). Two to three rabbits were euthanized on days 3 to 4, 7 to 11, 14 to 17, and 21 to 24 postoperatively. Both uterotubal junctions were excised, and step cross sections were obtained. The morphologic features including denuded epithelium with debris, submucosal fibrosis, hemorrhage, and fibrinoid matter in the tubal lumen and occluded lumen were observed. Results: Tubal lumina were successfully occluded in 10 of 14 tubes (71.4%) in group 1. In groups 2 and 4 none of the tubes were occluded, and in group 3 only three tubes were partially occluded. The difference between group 1 and other groups was significant (p < 0.05). Conclusions: The effects of bipolar coagulation in enhancing the inflammatory reaction on the mucosa and scar formation induced by fibrin sealant at the uterotubal junction in the rabbit were demonstrated. This sterilization method with the use of fibrin sealant may be developed into an outpatient procedure in humans and may be a new method for female sterilization in the future.

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      References

        • Brundin J
        Transcervical sterilization in the human female by hysteroscopic application of hydrogelic occlusive devices into the intramural parts of the fallopian tubes: 10 years experience of the P-block.
        Eur J Obstet Gynecol Reprod Biol. 1991; 39: 41-49
        • Richart RM
        • Neuwirth RS
        • Nielsen PA
        • William PG
        • Moore HM
        The effectiveness of the FEMCEPT method and preliminary experience with radiopaque MCA to enhance clinical acceptibility.
        in: PARFR series on fertility regulation. Harper and Row, Philadelphia1983: 212-218
        • Stevenson TC
        • Taylor DD
        The effect ofmethylcyanoacrylate tissue adhesive on the human fallopian tube and endometrium.
        J Obstet Gynaecol Br Commonw. 1972; 79: 1028-1039
        • Falb RD
        • Lower BR
        • Crowley IP
        • Powell TR
        Transcervical fallopian tube blockage with gelatine-resorcinol-formaldehyde (GFR).
        in: Advance in female sterilization techniques. Harper & Row, Hagerstown (MD)1976: 208-215
        • Zipper JA
        • Insunza C
        Pharmacological agents that potentiate or inhibit the occlusive action of quinacrine in the rabbit tube and rat uterus.
        in: Female sterilization. Academic Press, New York1972: 131-149
        • Dickinson RL
        Simple sterilization of women by cautery structure at the intra-uterine tubal openings compared with other methods.
        Surg Gynecol Obstet. 1916; 23: 203-220
        • Brundin J
        Intratubal devices.
        in: Biodegradables and delivery systems for contraception. MTP, Lancaster (United Kingdom)1980: 123-137 (Progress in contraceptive delivery systems series I)
      1. Tisseel two component fibrin sealant product information. Immuno AG, Vienna1992
        • Iaco PD
        • Costa A
        • Mazzoleni G
        • Pasquinelli G
        • Bassein L
        • Marabini A
        Fibrin sealant in laparoscopic adhesion prevention in the rabbit uterine horn model.
        Fertil Steril. 1994; 62: 400-404
        • Waclawiczek HW
        • Lorenz D
        Protection of the pancreatico-digestive anastomosis following resection of the head of the pancreas by pancreatic duct occlusion with fibrin glue: animal experiment and clinical experiences.
        Chirurg. 1989; 60: 403-409
        • Ross JA
        Sterilization; past, present, future.
        Population Council, New York1991 (Working papers No.: 29)
        • De Stefano F
        • Greenspan JR
        • Dicker RC
        • Peterson HB
        • Strauss LT
        • Rubin GL
        Complication of internal laparoscopic tubal sterilization.
        Obstet Gynecol. 1983; 61: 153-158
        • Layde PM
        • Peterson HB
        • Dicker RC
        • De Stefano F
        • Rubin GL
        • Ory HW
        Risk factors for complications of internal tubal sterilization by laparotomy.
        Obstet Gynecol. 1983; 62: 180-184
        • Hieu DT
        • Tan TT
        • Tan DN
        • Nguyet PT
        • Than P
        • Vinh DQ
        31,781 cases of non-surgical female sterilization with quinacrine pellets in Vietnam.
        Lancet. 1993; 342: 213-217
        • Richart RM
        Female sterilization using pharmacologically active agents.
        in: Research frontiers in fertility regulation. Harper & Row, Philadelphia1980: 262
        • Siegler AM
        • Grunebaum A
        The 100th anniversary of tubal sterilization.
        Fertil Steril. 1980; 34: 610-613
        • Sciarra JJ
        Hysteroscopic approaches for tubal closure.
        in: Research frontiers in fertility regulation. Harper & Row, Hagerstown (MD)1980
        • Cooper JM
        Hysteroscopic sterilization.
        Clin Obstet Gynecol. 1992; 35: 282-298
        • Froriep R
        Zur Vorbeugung der Notvendigkeit des Kaiserschnittes und der Perforation.
        Notizen Geb Heilk. 1849; : 211-215
        • Risques F
        • Confino E
        Transcervical tubal cannulation, past, present, and future.
        Fertil Steril. 1993; 60: 211-226
        • Kinahan TJ
        • Johnson HW
        Tisseel in hypospadias repair.
        Can J Surg. 1992; 35: 75-77
        • Tonotera R
        • Unruh HW
        Closure of a post-pneumonectomy bronchopleural fistula with fibrin sealant (Tisseel).
        Thorax. 1988; 43: 1015-1016
        • Feichtinger W
        • Barad D
        • Feinman M
        • Barg P
        The use of two-component fibrin sealant for embryo transfer.
        Fertil Steril. 1990; 54: 733-734
        • Quinones-Guerrero R
        • Aznar-Ramos R
        • Duran HA
        Tubal electrocauterization under hysteroscopic control.
        Contraception. 1973; 7: 195-201
        • Vancaillie TG
        • Eddy CA
        • Laufe L
        A new method of transcervical female sterilization.
        Fertil Steril. 1989; 51: 335-338