The fallopian tubes connect the uterus to the ovaries. In them, the fertilization of the egg occurs and its further movement to the uterus for fixation there. But in some cases there is no chance to save the female organs. In this case, a special operation is performed - tubectomy - removal of the fallopian tubes. The consequences for the body after such an intervention may be different, but they do not always occur.
Why are fallopian tubes removed
Surgical intervention to remove the fallopian tubes is carried out urgently or planned. Operation on the fallopian tubes is necessary for life-threatening violations of their functions, as well as anatomical anomalies.
Most often such intervention is necessary when:
- Tubal rupture due to ectopic pregnancy. This is accompanied by profuse internal bleeding and can be life-threatening. Therefore, removal of the fallopian tube during an ectopic pregnancy is a necessary measure.
- Undisturbed ectopic pregnancy when the situation cannot be corrected with conservative surgical therapy.
- Undisturbed but repeated tubal pregnancy on the same side.
- Inflammatory processes of a chronic nature - purulent salpingitis, salpingo-oophoritis, hydrosalpinx on the left or right. Such pathologies are not uncommon in recent years, their number is only growing from year to year. Early onset of sexual activity, sexually transmitted infections, abortions cause the development of inflammatory pathologies of the female genital organs, which lead to infertility.
- Pyosalpinx (accumulation of pus in the lumen of one or both fallopian tubes).
- Planning pregnancy with the help of reproductive technologies, if infertility is diagnosed that is not amenable to conservative therapy, caused by hydrosalpinx or chronic salpingitis. For example, with hydrosalpinx, fluid collects in the fallopian tube, which has a toxic effect on the endometrium and the fertilized egg, and may even prevent implantation, especially during exacerbation of the pathology. Removal of the tube in this case is necessary to increase the effectiveness of the IVF procedure. In addition, tubectomy prevents the onset of a possible tubal pregnancy. But at the same time, the intervention can lead to a deterioration in the maturation of the egg and suppression of ovulation, so it is usually recommended for large tubes and if hydrosalpinx is found on the left or right more than 6 months ago.
- Rupture of an ovarian cyst or torsion of its legs.
- Pronounced adhesive process, in which the appendages are also involved.
- Tubo-ovarian formations, large or multiple fibroids, malignant tumors, external endometriosis, oncology of the large intestine. Often, with such pathologies, the tube is removed along with the rest of the female organs.
- Gangrenous perforated appendicitis or Crohn's disease, which are accompanied by peritonitis, as a result of which the appendages were involved in the pathological process.
The operation to remove the fallopian tubes is carried out by laparotomy or laparoscopic method.
Intervention by laparotomy
This is an abdominal operation. The patient is made a longitudinal or transverse incision of the abdominal cavity. The first method is simpler, it is used in emergency cases, when you need to immediately stop heavy bleeding, as well as adhesions in the pelvis, volumetric neoplasms of various nature.
The second method is considered less traumatic, during the operation it is possible to apply a cosmetic skin suture, and the recovery period after the intervention is shorter. The indications for the use of this method are the same, but do not require emergency measures. The operation is also performed in this way if it is not possible to perform laparoscopy.
The operation itself on the fallopian tubes is carried out as follows:
- put clamps on the uterine tube and mesentery, which helps stop bleeding (if any);
- dissect adhesions, if anynecessity;
- having separated the pipe above the clamps, remove it.
If there are no adhesive processes, the abdominal cavity is not filled with much blood, then the operation lasts about forty minutes.
In some cases, instead of complete removal of the tubes, they are partially excised. This procedure is possible if the patient has:
- small areas covered by adhesive process;
- an ectopic pregnancy develops, but the tube has not yet ruptured;
- there is a benign tumor of a small size in one of the segments of the uterus.
Laparoscopic intervention
Carried out by introducing instruments into the abdominal cavity through three small incisions. During the intervention, a laparoscope is used, which has the form of a flexible tube with a camera at the end. An image is displayed on the monitor, which makes it possible for the gynecological surgeon to assess the condition of the reproductive organs, detect abnormalities and perform an operation.
Intervention performed by laparoscopy is less traumatic. The recovery period after treatment is short and easy.
Steps of operation:
- The abdomen is being prepared. For this purpose, an incision is made in the area near the navel, through which a Veress needle is inserted, through which the abdominal cavity is filled with carbon dioxide. Such manipulations allow you to raise the abdominal wall, which helps to better view the internal space.
- Removing the needle, replacing it with a laparoscope.
- Two more incisions are made, into which the gynecologist surgeon inserts instruments.
- After assessing the condition of the abdominal cavity and detecting the problematic organ, clamps are placed and the vessels are tied.
- The fallopian tube is removed.
- Tools are removed. Cosmetic sutures are applied to the puncture area with self-absorbable threads.
This procedure lasts from 40 minutes to an hour.
There are also contraindications to this type of removal of the fallopian tube. Laparoscopy is not performed if the patient has the following pathologies:
- Peritonitis.
- Tubal rupture with profuse bleeding.
- Heart attack, stroke.
- Malignant diseases of the female genital organs.
- Obesity grade 3 or 4.
- Diabetes mellitus in the stage of decompensation.
In such cases, the laparotomy method is used to remove the tubes.
Any of the interventions is carried out under general anesthesia. Laparoscopic salpingectomy requires the use of endotracheal anesthesia exclusively. Regional anesthesia (epidural or spinal) may be used if there is no bleeding.
Preparing for surgery
The patient is interested in what day to do a gynecological ultrasound, if there are indications for surgery. Diagnosis is carried out immediately before the surgical intervention. In addition, blood is taken from a woman for analysis, they also examine the abdominal cavity using ultrasound, doX-ray of the lungs.
Proper preparation for surgery is important. For seven days before the procedure, a woman must follow a special diet. The day before the intervention, it is recommended to cleanse the intestines using an enema, while eating and drinking should be limited. The patient also performs the necessary hygiene procedures, does depilation in the bikini area.
Rehabilitation period
In order to recover faster after excision of the fallopian tube, early physical activity is necessary. If the operation was performed laparoscopically, then the woman is allowed to get up after five to six hours. You can drink a little water, but only if the patient does not feel sick, she does not vomit, which often happens after surgery. After the laparotomy intervention, you can rise on the second day. But since pain can prevent a woman from moving, adequate pain relief will be needed.
Immediately after the intervention, it is recommended to eat foods that are easy to digest and do not contain a lot of fiber. There is no need for a special diet. At first, it is better to take liquid food, it is useful to use pureed soups, liquid cereals, and lactic acid products. If the bowel function is not disturbed, there is no nausea and vomiting, steamed or boiled food is allowed. Fresh fruits, vegetables, flour products and sweets should be avoided for the time being, as they contribute to increased gas formation. If a lot of blood was lost during the operation, the diet shouldinclude foods with a high content of vitamins, macro- and microelements.
Physical activity during the recovery period should be absent. You can return to sports after the permission of the doctor, but very gradually and slowly. Loads should be kept to a minimum.
It is strictly forbidden to lift heavy objects. You will also have to give up physical work for at least three months. If this is not possible, then it is worth at least reducing the load to a minimum, otherwise complications and he alth problems may appear.
In addition, there are restrictions on sexual contacts. Sex life is possible only after a month has passed after the operation. The main reason for this ban is the likelihood of infection entering the genital tract. Surgical intervention leads to a decrease in both general and local immunity, the body is not able to provide adequate protection. In addition, after surgical treatment, time is needed to restore the tissues that were affected during the operation. This usually takes about two weeks.
Before having sex, it is advisable to visit a doctor. After the examination, the specialist will be able to tell how the healing process is going, whether the infection has joined, whether other complications have arisen.
Postoperative therapy includes antibacterial drugs, anti-inflammatory drugs, vitamins. To prevent the occurrence of an inflammatory process, it is recommended to carry outphysiotherapy. Most often, iono- and phonophoresis, laser and magnetotherapy are used.
To prevent the formation of adhesions are recommended:
- injection into the abdominal cavity at the end of the operation of absorbable barrier gels that protect the surfaces of organs from contact;
- minimal physical activity the day after the intervention;
- electrophoresis with iodine and zinc;
- use of subcutaneous injections of aloe extract for two weeks, vaginal suppositories "Longidaza" may be prescribed;
- proper suture care to prevent inflammation (instead of a bath, it is recommended to take a shower, covering the suture area to avoid water ingress);
- wearing slimming underwear for a month after surgery.
After surgical treatment, a woman may observe the appearance of bloody discharge from the vagina, which should not cause concern. This is due to the backflow of blood into the uterus during the operation.
Menstruation after removal of the fallopian tube may begin in a few days if the recovery is fast or there are some disruptions at the hormonal level. This is also not a cause for concern if the nature of menstruation has not changed. If bleeding is heavy, scraping may be necessary.
In the event that menstruation does not begin two months after the intervention, it is necessary to consult a gynecologist. Women's he alth requires attention, so you should not run the situation.
Postoperative complications
After surgery, the following complications may develop:
- Inflammatory process. Immediately after surgery or a few days later, a woman may experience a fever, which indicates the development of inflammation.
- Bleeding, bruising in the abdominal cavity. Such violations indicate that the patient's blood clotting is impaired or the hemostasis procedure was performed incorrectly.
- The appearance of nausea and vomiting. Such signs may occur as a reaction to the introduction of anesthesia, and the cause may also be intestinal irritation after laparoscopic surgery with the introduction of carbon dioxide into the abdominal cavity.
- Spikes that interfere with the work of internal organs. The possibility of their appearance exists after an operation performed in any way. A sign of the adhesive process will be pain after the procedure. In the future, adhesions can affect the intestines, which will affect its patency.
It should be noted that these complications are rare.
Consequences for the body
According to many gynecological surgeons, the fallopian tubes are necessary only so that the egg can pass through them, and surgery in this area does not affect the state of the body as a whole.
But scientific research proves otherwise, because the uterus with tubes and ovaries are a single system. So, in almost half of the patients who underwent surgery, after some time they maydevelop symptoms that indicate disorders in the activity of the neuroendocrine system. These signs include:
- appearance of excess weight;
- excess hair growth;
- malfunctions of the thyroid gland;
- breast tenderness and engorgement.
The consequences of the removal of the fallopian tubes for the body may be different. Women who underwent surgery note that their blood pressure often began to rise, headaches and dizziness appeared. Also, patients suffer from hot flashes and excessive sweating, increased emotionality, mental instability, and rapid heartbeat. Such manifestations begin to occur after a long delay in menstruation, and this phenomenon is observed in about 30% of the fair sex who have undergone removal of the fallopian tubes. Consequences for the body begin to appear a few months after the intervention, menstrual irregularities occur, ovulation may be absent, the functions of the follicles and the corpus luteum decrease.
After an instrumental study, it is possible to detect a violation of the lymph and blood circulation in the area of intervention, abnormal development of follicles, an increase in the ovary on the operated side.
With bilateral removal of the tubes, all of the listed signs will be more pronounced, while there is a risk of early onset of menopause.
Is it possible to get pregnant after the removal of the fallopian tube
The only way to have a baby after bilateral tubal removal is IVF. If one trumpet remains, the chancefor natural insemination and pregnancy is present in approximately 60% of women who have undergone surgery.
Before the in vitro fertilization procedure, it will be necessary to undergo a series of examinations to assess the hormonal background, determine the thickness of the endometrium, and detect diseases of the female genital organs. The results of the diagnosis will help to understand whether a successful pregnancy is possible. Also, a woman will need to pass a biochemical blood test and for infections, a urinalysis, swabs from the genital organs, be examined by a therapist and a mammologist. On what day to do a gynecological ultrasound, the gynecologist will tell you, but usually it is carried out on the 5-8th day of the cycle. Both spouses will also need to be tested for HIV and hepatitis.
If the state of he alth of the spouses does not cause concern, preparation for fertilization will consist in protecting the expectant mother from stress, colds and other diseases, obtaining the vitamins and minerals the body needs from food or with the help of multivitamin complexes.
When you can plan a pregnancy
You can plan pregnancy no earlier than six months after the intervention. Best if 12 months pass. Until then, oral contraceptives must be used. Such drugs allow you to relax the ovaries, help to avoid unwanted conception during this period, restore the tone of the remaining fallopian tube. Also, oral contraceptives contribute to the normalization of hormonal levels, and this is very important for the onset and subsequent successful bearing of a child, even inif one fallopian tube remains.
After the abolition of hormonal drugs, the couple can start an active intimate life and not be protected. It may take from 6 months to a year for pregnancy to occur, which is a normal option.
Hurrying with pregnancy is also not worth it because its onset soon after surgery can lead to the fact that the embryo will be fixed outside the uterine cavity, and this will require repeated intervention and removal of the second tube, which means infertility.
It is important to consult a specialist before planning, and also ask what day of the cycle to do a gynecological ultrasound to assess the condition of the tubes.
If there is a need, in the presence of neuroendocrine failures, hormone replacement therapy is prescribed. The treatment regimen and the duration of the course are determined by the specialist.
Is it possible to restore the pipes after surgery
In the event that only part of the pipe was removed during the operation, plastic surgery is possible. Such a procedure is carried out only when there is a chance to become pregnant naturally. With the complete removal of the fallopian tubes, recovery is impossible.
To prevent severe complications in inflammation of the appendages and other pathologies, removal of the fallopian tubes helps. The consequences for the body are not always negative, in some cases such a measure even helps to get pregnant, even with the help of in vitro fertilization.
