Hysteroscopic and hysterosalpingographic study after intrauterine insertion of quinacrine pellets for non-surgical sterilization
El Sahwi, S.; Kamel, M.; Haiba, N.; Osman, M.
Advances in Contraceptive Delivery Systems Cds 8(1-2): 151-159
1992
ISSN/ISBN: 1012-8689 PMID: 12285561 Document Number: 537389
Sixty fertile females seeking permanent contraception were included in the study. All cases received three applications of seven 36 mg Quinacrine hydrochloride pellets during the proliferative phase of three consecutive menstrual cycles. The patients were randomly divided into three groups A, B and C. Hysterosalpingography was performed on 8th day of menstruation and hysteroscopy on 10th day of same cycle after 1st application in group A, 2nd application in group B and 3rd application in group C. Hysterosalpingography showed 17 cases of bilateral obstruction, one case of bilateral patency, and two cases of unilateral patency in group A, while in group B and C, all elicited bilateral tubal occlusion. Cornual obstruction was seen in 33%, 65% and 85% in group A, B and C, respectively. Intramural obstruction was seen in 50%, 33% and 10% in the three groups. Hysteroscopy showed no abnormal findings in group A, while 35% and 85% of cases in group B, and C showed some changes. Four types of ostial appearances could be recognized hysteroscopically. Type 0 (patent tubes), Type I (distal tubal blockage), Type II (intramural obstruction) and Type III (cornual obstruction). In group A, Type O was seen in 10%, Type I 80%, Type II 50%, Type III 33% of cases. The respective figures in group B were 0%, 2.5%, 33% and 65%, while in group C 0%, 5%, 10% and 85%. Two applications of quinacrine are 100% effective, the hysteroscopic endometrial changes detected were transient. The possibility of reversal of the procedure is outlined.