Transcervical tubal occlusion using methyl cyanoacrylate: the two-application technique.

This article reports a clinical trial of the 2-application methyl cyanoacrylate (MCA) technique using the FEMCEPT device to produce tubal occlusion. 47 of the 50 cases had nonradiopaque MCA injected twice. There were no serious complications although hospitalization was required for 1 patient who experienced abdominal pain and vaginal bleeding 3 weeks after the procedure. Complaints of pain were noted to be more frequent among private patients from higher socioeconomic levels than among women from the lower socioeconomic group. Hysterosalpingograms 4 months after the 2nd injection were obtained in 41 patients 39 of whom demonstrated bilateral closure. 1 woman had bilateral patency and the other had a unilaterally patent tube. Being a nonsurgical procedure the MCA technique does not invade the peritoneal cavity does not require anesthesia is simple to execute by medical and paramedical personnel and does not involve sophisticated expensive instruments. No mortality or life-threatening complications have been reported to date. Disadvantages of the method include the frequent need for 2 applications the long waiting period before effective blockage can be proved the high failure rate and its doubtful reversibility. A repeat procedure is difficult to implement in developing countries and the need for contraception for 4 months after the procedure represents another drawback. Although laparoscopy and minilaparotomy are quickly executed immediately effective and possibly reversible these procedures require physician training and skill expensive equipment use of anesthesia and involve a small but significant morbidity and mortality.