Sterilization with fibrin sealant in a rabbit uterine horn model


      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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