Hysteroscopic sterilization with occlusion of sheep uterine tube using n-butyl-2-cyanoacrylate adhesive

Abstract

Purpose:To evaluate the fertility and analyze the macroscopic, microscopic and morphometric aspects of sheep uterine tube sterilization with a hysteroscopically insert of n-butyl-2-cyanoacrylate adhesive. Methods: 12 adult sheep, with one previous pregnancy, were distributed as follows: group L (n=3) subjected to laparotomy and Pomeroy uterine tube ligation, group S (n=3) subjected to hysteroscopic application of saline solution in tube isthmus and group AD(n=6), that was subjected to hysteroscopic application of 0.5 ml of n-2-butil-cyanoacrylate in tube isthmus. They were mated with fertile males for ninety days. The non pregnant sheep, at the 90th day, were subjected to laparotomy with uterus and tubes uterine resection. The fragments of uterine tubes were fixated in 10% formalin and processes for histology evaluated, and slices dyes for H.E. Data were evaluated by Wilcoxon and Mann-Whitney and Fisher's exact test. Results: All sheep from groups L and AD did not get pregnant (0%) in contrast with sheep from group S (100%); the adhesive remained integral in the uterine tube lumen. The percentual of adherences (66.6%) and fibrosis responses (100%) was significantly higher in the group L than group AD (0%) (p≤0.01). The diameter of the caudal tube in group AD (2652.15 ± 45.76 mm) was significantly wider than that of the group L (1868.27 ± 56.11* mm) (p ≤ 0.05). Conclusion: The hysteroscopic insertion of cyanoacrylate in the uterine tube lumen of sheep was effective to obstruct the uterine tube and to promote the sterilization. Key Words: Fallopian Tubes. Sterilization, Reproductive. Tissue Adhesives. Sheep. RESUMOObjetivo: Avaliar a fertilidade e aspectos macroscópicos, microscópicos e morfométricos da esterilização histeroscópica de tubas uterinas de ovelhas com o adesivo de n-butil-2-cianoacrilato. Métodos: 12 ovelhas adultas, com uma prenhez anterior, foram distribuídas como segue: o grupo L (n=3) submetidas à laparotomia e laqueadura tipo Pomeroy, grupo S (n=3) submetidas à aplicação histeroscópica de solução salina no istmo tubário e grupo AD (n=6), com aplicação histeroscópica de 0,5 ml de cianoacrilato. As ovelhas foram acasaladas com machos de comprovada fertilidade por noventa dias. As ovelhas não prenhes aos 90 dias, foram submetidas à laparotomia com ressecção do útero e tubas uterinas, que foram fixadas em formalina 10%s e os cortes histológicos corados em hematoxilina/eosina. Os resultados foram avaliados pelo teste de Wilcoxon e teste exato de Fisher. Resultados: Todas as ovelhas dos grupos L e AD não ficaram prenhes (0%) ao contrário das ovelhas do grupo S (100%); o adesivo permaneceu íntegro no lúmen tubário. O percentual de aderências (66.6%) e de fibrose (100%) foi significativamente maior no grupo L do que no grupo AD (0%) (p≤0,01). O diâmetro da porção caudal no grupo AD (2652,15 ± 45,76 mm) foi significativamente maior do que grupo L (1868,27 ± 56.11 mm) (p≤0,05). Conclusão: A inserção histeroscópica do cianoacrilato no lúmen tubário de ovelhas foi eficaz para obstruir a tuba uterina...

Transcervical hysteroscopic sterilization using cyanoacrylate: A long‐term experimental study on sheep

“…The animals were placed in dorsal recumbency on the operating table and submitted to a standard hysteroscopy procedure as described previously 9 . A vaginal speculum was positioned for the identification of the cervix; it was grasped and pulled to visualize the external orifice of the cervix.…”

“…Another patency postmortem test was performed by injecting 20 mL of methylene blue through the same double‐lumen catheter under pressure (80 mmHg). We then observed the eventual escape of the dye through the fimbriae 8,9 …”

“…The transcervical hysteroscopy instillation of n‐butyl‐2‐cyanoacrylate is an effective method of promoting of tubal occlusion in rabbits 6,7 . In sheep, over the course of 90 observation days, the adhesive was effective in ensuring sterilization 8,9 . In both animal models the adhesive plug remained intact in the tubal lumen and no macrophage cells were identified in optical microscopy visualization utilizing casts of the polymers inside.…”

“…The hypertrophy of myosalpinx may be associated with the effort invested in peristaltic movements to remove the adhesive plug. The mucosa remained intact, but it exhibited decreased thickness 6–9 …”

Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

“…The non-closure technique was associated to pelvic viscera adhesions (47%) 17 . Otherwise, the fibrin glue is a current biological surgical adhesive employed in several organs and tissues including in uterus and uterine tube [18][19][20][21] . It is used as a safe and reliable material on haemostatic and suture procedures.…”