Transcervical Insertion of Quinacrine Pellets

Objective-To determine the effect on tubal closure of intrauterine quinacrine by dose and time from administration. Design and Participants-Subjects included 33 women of reproductive age who were awaiting hysterectomy for nonmalignant conditions at a Bombay, India medical college. Ten women received 252 mg quinacrine as pellets using a modified Copper-T IUD inserter followed by hysterectomy within 6 weeks, and 23 women received 324 mg quinacrine followed by hysterectomy 6 to 20 weeks post-insertion. Hysterosalpingograms were done before insertion, prior to surgery and on the fresh surgical specimen. The uteri and tubes were subjected to histology studies, including grading of tubal damage. For study of dose, an additional 7 women receiving 100 mg quinacrine (and previously reported) were included. Main Outcome Measure-Tubal closure rates by hysterosalpingogram and tubal histology. Results and Conclusion-Tubal closures were directly related to quinacrine dose and length of insertion-hysterectomy interval. For the 252 mg quinacrine dose, 55.0% of intramural tubal segments and 5.9% of isthmic segments showed histologic evidence of closure. For the 324 mg dose, all intramural tubal segments and 58.8% of isthmic segments showed histologic evidence of closure. Clinical conditions, such as dysfunctional uterine bleeding, were associated with lower tubal closure rates. Multivariate discriminant analysis showed quinacrine dose to be more important than quinacrine-hysterectomy interval. Int J Fertil 40( 1):47-54, 1995