Distribution of liquids introduced into the uterus with a simple “nonocclusive” cannula

In order to investigate possible reasons for inconsistent tubal occlusion when a suspension of quinacrine is introduced into the uterus, the following radiographic investigations were carried out: 4ml of renografin 60 which has the same approximate viscosity as a suspension of quinacrine, were introduced into the uteri of sixteen normal parous women and the distribution followed by fluoroscopy and x-ray. The same type of instrument which had previously been used to introduce quinacrine, namely, a 3.4mm cannula with no cervical occlusive tip, was employed. The contrast material failed to enter one or both oviducts in four out of sixteen cases (25%), even though subsequent hystero-salpingograms revealed patent oviducts. However, if patients wearing IUDs were excluded, renografin 60 failed to enter the patent oviducts in only one out of eleven cases (9%). A much more viscous contrast material, Salpix, failed to enter patent oviducts in one out of thirteen women (8%) including three who were wearing IUDs. There was less peritoneal spillage with the more viscous contrast material. These studies suggest that failure of a suspension of quinacrine to enter the oviduct is at least one reason for failure of this technique to occlude the fallopian tube. They also suggest that a more viscous preparation may lead to more consistent filling of the oviducts when a cannula without an occlusive tip is used to introduce the preparation into the uterus.