In case of violation of the patency of the fallopian tubes, there are no bright symptoms, and a woman may not know about the developing problem for quite some time. The state of he alth is not disturbed in any way, the duration and nature of menstruation also do not change, there are no cycle failures. It does not matter which fallopian tube is impassable. Even a blockage in one of them can lead to infertility.
Signs
An important and clear sign indicating the appearance of obstruction of the uterine appendages is the inability of a woman to become pregnant even if she has regular sex without contraception.
Given the cause that provoked the appearance of obstruction, its clinical picture may also vary.
If the cause of blockage of the tubes is adhesive disease due to inflammation of the reproductive organs, the patient is worried about painful, aching sensations in the lower abdomen.
If the obstruction developed after surgery, then the pain is more likelyeverything will be pulling. Sometimes it becomes very intense, disrupting the quality of life. A woman may experience pain during intercourse when the vagina is stretched.
A symptom that makes it possible to determine the blockage of the tubes is severe pain during a normal menstrual cycle.
Common symptoms
So, let's determine the most likely symptoms of obstruction of the uterine tubes:
- Painful sensations during menstruation. Periodically occurring pains of aching or pulling nature in the lower abdomen.
- Discomfort during intercourse.
- Pathological vaginal discharge.
Causes of blockage
Tubal obstruction is a big problem for a woman's body.
There are several causes of blocked fallopian tubes:
- diseases of the pelvic organs (adnexitis, inflammation of the cervix, ovarian cysts, inflammation of the vaginal mucosa);
- sexually transmitted infections (HIV, herpes, hepatitis);
- termination of pregnancy, ectopic pregnancy;
- myoma;
- spikes;
- abdominal surgery.
Why can't get rid of it?
The reasons why it is impossible to get rid of obstruction of the fallopian tubes are different:
- The most common is the woman's age (35 years and above).
- Presence of inflammation of the urogenital organs and inflammation of the organs of the reproductive system.
- Genital TB.
- Accumulation of fluid in the lumen of the tubes.
- Spikes.
If it is impossible to restore tubal patency, the patient is offered IVF, as a result of which the embryos are injected directly into the uterine cavity, bypassing the oviducts.
How is the fallopian tubes checked for patency?
Several methods are used for diagnosis. Among them:
- Ultrasound of the fallopian tubes is a modern affordable diagnostic method that allows you to determine diseases of the female reproductive system, such as anomalies in the structure of organs, the presence of inflammation, adhesions and tumors.
- Echohysterosalpingography or hydrosonography is a diagnostic procedure that involves injecting sterile saline into the cervix and determining the passage of fluid through the fallopian tubes using an ultrasound probe.
- Hysterosalpingography, or metrosalpingography, is the main and most informative diagnostic method, its efficiency is up to 98%. The study consists in the introduction of a contrast agent through a special catheter into the uterine cavity and a series of x-rays, which can be used to assess the shape and structure of the uterus, as well as the condition and patency of the fallopian tubes. As a contrast agent, water-soluble X-ray contrast agents are used - Cardiotrast, Verographin, Urografin. Using this technique, the doctor can determine the presence of obstruction of the fallopian tubes, however, additional studies are needed to clarify the cause of the pathology.
- Pertubationfallopian tubes or "blowing" - a study in which an obstetrician-gynecologist, using a special apparatus, introduces oxygen into the cervix. If the gas flows freely into the abdominal cavity through the pipes, the pressure gauge installed in the device will indicate the pressure drop in them. In the case when there is an obstruction, air will accumulate in the uterus, and this will be displayed on a manometer. When evaluating the data obtained, the doctor also takes into account the presence of noise in the abdominal cavity and pain in the patient's collarbones.
- Laparoscopy with chromotubation is a minimally invasive surgical technique, most often used not only for diagnostic, but also for therapeutic purposes. Under anesthesia, special instruments are introduced into the abdominal cavity through small holes in the patient, allowing to assess the condition of the pelvic organs and perform the necessary manipulations. The operation can be supplemented with chromotubation - the introduction of a sterile colored liquid into the uterine cavity and an assessment of the passage of the liquid through the tubes.
- Fertiloscopy or transvaginal hydrolaparoscopy - this procedure is more easily tolerated by women and is performed under local anesthesia in an outpatient clinic. Unlike the previous technique, access is made not through the abdominal wall, but through the posterior surface of the vagina.
Before the diagnosis, you need to consult a doctor, only he can prescribe the necessary procedure after a thorough examination of the woman. Examination should begin with affordable and minimally invasive studies, and only if necessary, switch to surgical diagnostic techniques.
Recovery Methods
Tubal obstruction is treated with various conservative and surgical therapies.
The most effective method in modern gynecology is surgery, the most common of them are laparoscopy, fertiloscopy, hydrotubation, recanalization.
The first two types of manipulations are most often used: fallopian tube laparoscopy and fertiloscopy.
Laparoscopy
Laparoscopy of the fallopian tubes has a huge advantage over other methods, since, having the highest efficiency, it is a minimally invasive technique compared to conventional surgical interventions. Such an operation is more easily tolerated by women, and recovery is much faster. All medical manipulations are carried out through several small incisions using an endoscope and special laparoscopic instruments. Based on the degree and etiology of tubal obstruction, during the laparoscopic operation, these manipulations can be performed:
- Fimbriolysis - cilia, or fimbria, of the fallopian tube are freed from adhesive synechia.
- Salpingo-salpingoanastomosis - the section of the tube affected by adhesions is excised, then both parts are sutured together.
- Salpingostomatoplasty - the affected part of the appendage is removed and the tube is reconstructed with an anatomically correct lumen.
- Salpingolysis - dissection of adhesive adhesions of the fallopian tube. With a successful outcome of surgery, pregnancy may occur in a few months.
- Tubal ligation is used to prevent the growth of blocked tubes.
Fertiloscopy
Fertiloscopy is the second method of surgical treatment using endoscopic and laparoscopic instruments. Fertiloscopy is considered more gentle, since access to the female reproductive organs is carried out through the back wall of the vagina. With the help of an optical system, a thorough examination of the fallopian tubes is performed, and the necessary manipulations are performed. This procedure is also performed on an outpatient basis, under local anesthesia.
Hydrotubation
Hydrotubation is a treatment method based on the mechanical removal of adhesions by supplying an isotonic sodium chloride solution into the tubes under pressure, as well as introducing drugs into the lumen of the fallopian tubes. To achieve the result, it is recommended to perform several sessions within 1-5 menstrual cycles. This method of treatment is considered obsolete in many clinics, but in some cases, for example, when there are contraindications to surgical treatment, it is successfully used.
Recanalization
Recanalization is another type of pathology treatment. Effective with a slightly pronounced adhesive process and the predominant location of adhesions at the mouth of the appendage. A special catheter with a balloon at the end is inserted into the fallopian tube through the uterus. The doctor, gradually moving the catheter along the lumen of the fallopian tube, inflates the air in the balloon, thereby straightening it and eliminating the obstruction. After treatment, regardless ofof the chosen method, patients are prescribed anti-inflammatory and anti-adhesion therapy.
Complete obstruction
100% obstruction of the uterine tubes can be treated only if their structure is not severely damaged or if adhesions are located outside the adnexa. Also, treatment can be started in the absence of acute inflammatory processes in a woman. It is noteworthy that after the procedure for restoring the patency of the uterine appendages, it is not always possible to get rid of infertility. It is important to restore the proper functioning of the tubes so that they have the opportunity to move the fertilized egg deeper into the uterus. If this is not achieved, there is a risk of an ectopic pregnancy.
To get rid of the problem will not work in such cases:
- the presence of an inflammatory process in the urinary organs;
- patient over 35;
- genital tuberculosis;
- frequently occurring exacerbations of inflammation;
- discovered hydrosalpinx, which is large;
- a large number of adhesions in the abdomen that splice organs together;
- adhesions in the inside of the fallopian tubes.
It is important to take into account that after the normalization of the patency of the uterine tubes, it is impossible to 100% guarantee a full-fledged work!
ECO
When diagnosing a diagnosis of "obstruction of the fallopian tubes" in women, in vitro fertilization is possible. It will be justified after the treatment of chronic diseasessexual sphere. Mandatory full-fledged treatment of the infection, up to the removal of the uterine tubes, gives prospects for positive results.
Removal of the fallopian tubes can be a popular method in case of a large deformation of the appendages or a violation of the position of the uterus, which exacerbates the threat of termination of pregnancy with successful fertilization.
Other reasons for removal include:
- Low chance of tubal patency.
- It is impossible to fully eliminate the inflammatory disease.
In vitro fertilization for tubal obstruction is the choice of women for the following reasons:
- With complete blockage of the fallopian tubes, it becomes more difficult to get pregnant and carry a baby.
- IVF is becoming the last hope for women, which entails a positive result.
- After surgery, the chances of conception are reduced, the adhesion process in the tubes in the advanced stages of the disease will reduce the chance of conception to 20%.
- IVF procedure in 65% of cases will help women with a low chance of conceiving up to 35 years of age to become pregnant. In such cases, IVF should not be abandoned.
- When the fallopian tubes are blocked, the risk of ectopic pregnancy increases. During the IVF procedure, it is reduced to 2%.
- It becomes possible to learn about IVF results in ten days.
Folk remedies
In the treatment of fallopian tubes, the following means are used:
- Plantain seeds. Necessaryprepare a medicinal decoction from a plant: a glass of water is heated, 1 tbsp is added. plantain seeds. After that, the broth is aged for half an hour in a water bath and filtered. The decoction is applied 4 r./d. 2 tablespoons before meals. To get rid of the obstruction of the uterine tubes, drink the decoction in a course of 60 days.
- 1 tbsp Wintergreen added to 1 tbsp. boiling water and kept for 40 minutes in a steam bath. The broth is cooled, boiled water is brought to a volume of 250 ml. Means to use 3 rubles / day. 1/3 cup each.
- You can also prepare a healing tincture from wintergreen: pour 500 ml of vodka into 2 packs of the plant, then leave the infusion, shaking occasionally. After 18 days, the infusion is filtered and taken before meals, 25 drops for 3-6 months.
