Determining the patency of the fallopian tubes is one of the most important methods for identifying the cause of female infertility. Statistics show that in 35% of cases the inability to get pregnant is due to the tubal factor. The presence of adhesions, fusions or other anomalies prevents the fertilization of the egg by the sperm, the further advancement of the zygote into the uterine cavity. To detect pathology, modern medicine offers various diagnostic procedures. One of these is hydrotubation of the fallopian tubes.
Medical certificate
Under hydrotubation, it is customary to understand a medical and diagnostic procedure, the essence of which is the introduction of a special fluid into the oviducts. Thanks to this minimally invasive technique, it is possible to determine the degree of patency of the fallopian tubes, and, if necessary, to eliminate existing pathologies in a gentle way.
Indications for prescription
The fallopian tubes play an important role in conceiving a child. A mature egg moves along them from the ovary to the uterus, male gametes move forward. This is where the process startsfertilization. If the patency of the oviducts is disturbed, the woman has problems conceiving. In especially serious cases, they cause infertility.
Fallopian tube blockage can occur for a variety of reasons. However, the most common are a history of infectious diseases of the pelvic organs, frequent abortions, hormonal disruptions.
Indications for tubal hydrotubation are the following he alth problems:
- Partial or complete fusion of tubal cavities.
- Adhesion processes in the appendages.
- Assessment of tubal patency after unilateral tubectomy.
- The period of observation of the oviduct after surgery.
If the orifices of the fallopian tubes are narrowed, will hydrotubation help? The answer will always be positive. This procedure is effective, including in such pathology.
What are the contraindications?
Like any other medical procedure, hydrotubation has some contraindications. The procedure is not recommended in the following cases:
- inflammatory processes in the pelvic organs;
- autoimmune pathologies;
- oncological diseases;
- vaginal bleeding;
- diseases of the cardiac system.
Preparatory stage
Obstruction of the fallopian tubes does not belong to the category of emergency pathologies. Therefore, before hydrotubation of the fallopian tubes, the patientcarefully prepared. The procedure is recommended to be performed from the 7th to the 24th day of the menstrual cycle.
A few days before the date of the intervention, the woman must take blood and urine tests, a gynecological smear. If the latter shows a violation of the microflora, therapeutic treatment is prescribed. Only after its completion can hydrotubation be carried out. The procedure will also be denied if urine and blood tests show an inflammatory process in the body.
Immediately before the start of the study, the patient must completely empty the intestines and bladder. The gynecologist should tell you about other restrictions at the consultation.
Progress
Tubal hydrotubation does not require hospitalization. All manipulations are carried out in a hospital.
First, the doctor treats the external genitalia of a woman with iodine or any other antiseptic. Then, through the vagina, he injects a special solution through a syringe to which a manometer is attached. The latter allows you to monitor the pressure. Its performance should not exceed 200 mm Hg. st.
To check the patency of the fallopian tubes, saline is injected. In especially serious cases, a contrast agent is added. The patency of the pipes allows you to evaluate the pressure gauge. In the absence of obstacles in the path of the liquid, the pressure first decreases slightly, and then remains at the same level. With obstruction, this parameter is gradually increased. In addition, after all the manipulations, saline will flow out.
Liquid suppliedinto the pelvis, dissolves on its own. Additional action by the doctor is not required. After the diagnostic procedure, the patient is observed for some more time, after which they are allowed to go home.
Tubal obstruction can be partial. In this case, the liquid enters the vagina after a few minutes or hours. If a pathological process is suspected, the doctor warns the woman in advance about possible discharges. The patient, in turn, must notify the doctor if such a situation arises.
Therapeutic hydrotubation
This procedure is also carried out for therapeutic purposes. The auspicious time is the intermenstrual period. Usually it takes about 5-6 manipulations over several cycles.
The method of hydrotubation of the fallopian tubes is practically the same as when the procedure is prescribed for diagnostic purposes. However, the following drugs are used instead of saline:
- antibiotics ("Penicillin", "Streptomycin");
- corticosteroids to eliminate inflammation ("Hydrocortisone", "Prednisolone");
- Lidase is used to dissolve the adhesive process;
- proteolytic enzymes with antimicrobial effect ("Trypsin").
The procedure is usually prescribed in combination with electrophoresis and gynecological massage. Throughout the entire period of treatment, it is important to exclude sexual intercourse or use barrier contraceptives.
According to reviews, hydrotubation of the fallopian tubes,carried out for therapeutic purposes, gives a positive result only under the condition of non-stop treatment for three cycles or more. However, their number may vary depending on the state of he alth of the patient, the presence of concomitant pathologies, the body's response to treatment.
Possible Complications
Approximately 5% of patients are accompanied by complications hydrotubation of the fallopian tubes. The consequences of a negative nature are expressed in the following violations:
- temperature increase;
- oviduct spasms accompanied by painful syndrome;
- rupture of the fallopian tube due to the introduction of a large volume of fluid;
- allergy to medications used;
- exacerbation of inflammatory processes in the pelvic organs.
The most common complication is pain. It may be accompanied by pallor of the skin, respiratory failure and a decrease in heart rate.
Pregnancy after procedure
After a course of therapy, pregnancy can occur already in the first cycle. However, in most cases, it ends in a miscarriage in the early stages or turns out to be ectopic. Therefore, doctors recommend using contraceptives for 2-3 cycles. Only after the end of the rehabilitation period can conception be planned. Approximately one third of women have a positive result.
After hydrotubation, most patients have a normal course of menstruation, recoverylibido and female cycle. If attempts to get pregnant fail, doctors recommend IVF. The procedure involves fertilization of the egg outside the body with further implantation of the embryo into the uterus.
Advantages of the technique
Hydrotubation of the fallopian tubes is an effective procedure with which you can determine the cause of the obstruction. It has some advantages when compared with other diagnostic options.
One of the main advantages is security. The technique does not involve the use of ionizing radiation, so it does not harm the woman's body. If necessary, it can be repeated several times in a row.
Another advantage is the lack of need for hospitalization. After manipulations, a woman can return to her business on the same day. The study is carried out quickly, and the results are known immediately. Tubal hydrotubation is a relatively cheap and common procedure. Today, almost every medical center has the tools to carry it out.
Separately, it is necessary to mention the high accuracy and information content of this diagnostic method. In the standard version, a conventional two-dimensional examination is performed, which does not allow a complete view of the fallopian tube. It bends in three planes. The solution to this problem is 3D and 4D ultrasound, which can be used to build a three-dimensional image.
Medical statistics show that hydrotubation allows you to get results that in 91% of casessimilar to laparoscopy. The reason for the discrepancies lies in the fact that ultrasound is an operator-dependent research method. Here, much depends on the qualifications of the specialist performing the procedure and his experience. In addition, extraneous factors also affect the quality of ultrasound examination. We are talking about gases in the intestines, a high degree of obesity, etc.
