Clinicopathologic study of fallopian tube closure after single transcervical insertion of quinacrine pellets
Merchant, R.N.; Prabhu, S.R.; Kessel, E.
International Journal of Fertility and Menopausal Studies 40(1): 47-54
1995
ISSN/ISBN: 1069-3130 PMID: 7749435 Document Number: 288107
At B.Y.L. Nair Hospital in Bombay, India, physicians compared data on 10 women who had received 252 mg quinacrine in pellet form transcervically followed by a total hysterectomy within 6 weeks of quinacrine insertion with data on 23 women who had received 324 mg quinacrine in pellet form transcervically followed by a total hysterectomy 6-20 weeks after insertion. All the women were already scheduled for a hysterectomy for nonmalignant conditions. The researchers also included data on seven other women who had received 100 mg quinacrine earlier. They wanted to examine the effect on tubal occlusion of intrauterine quinacrine by dose and time. They conducted hysterosalpinograms before insertion, prior to hysterectomy, and on the fresh surgical specimens of the tubes and uterus. Women receiving the 324 mg dose had a much higher tubal closure rate than those receiving a 252 mg dose (100% vs. 50%; p = 0.01). With the 325 mg dose, all intramural tubal segments and 58.8% of isthmic segments had histologic stage II or III closure. With the 252 mg dose, 55% of intramural tubal segments and 5.9% of isthmic segments had stage III closure. A quinacrine-hysterectomy interval of at least seven weeks resulted in a better tubal closure rate than that of less than seven weeks (22/24 vs. 9/16; p = 0.01). Clinical conditions (pooled data; myomas, dysfunctional uterine bleeding, cervical intraepithelial neoplasia, and prolapse) were positively associated with tubal closure (31/40 vs. 9/40; p = 0.02). Quinacrine dose had a more significant effect on tubal closure than quinacrine-hysterectomy interval (standard discriminant function coefficient, 0.55 vs. 0.35).