Determination of patency of the uterine (fallopian tubes) is one of the most important methods for identifying the causes of female infertility. Statistics show that in 35% of cases the inability to get pregnant is due precisely to the pipe factor. The presence of adhesions, fouling, or other abnormalities prevents the fertilization of the egg by the sperm, the further advancement of the zygote into the uterine cavity. To identify the pathology, modern medicine offers various diagnostic procedures. One of these is tubal hydrotubation.
Medical certificate
Hydrotubation is usually understood as a diagnostic and treatment 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 appointment
Fallopian tubes play an important role in the conception of a child. A mature egg moves from them from the ovary to the uterus, male gametes advance. The fertilization process begins here. If the patency of the oviducts is impaired, the woman has problems conceiving. In especially serious cases, they cause infertility.
Fallopian obstruction can occur for a variety of reasons. However, the most common infectious diseases of the pelvic organs in history, frequent abortions, hormonal disruptions.
The following health problems are indications for tubal tubing:
- Partial or complete overgrowth of tube cavities.
- Adhesion processes in the appendages.
- Assessment of tube patency after unilateral tubectomy.
- The period of observation of the oviduct after surgery.
If the mouths of the fallopian tubes are narrowed, will hydrotubation help? The answer will always be positive. This procedure is effective, including with such a 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 heart system.
Preparatory stage
Fallopian obstruction does not belong to the category of emergency pathologies. Therefore, before hydrotubation of the fallopian tubes, the patient is carefully 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 intervention, a woman should take blood and urine tests, a gynecological smear. If the latter shows a violation of microflora, therapeutic treatment is prescribed. Only after its completion can hydrotubation be carried out. The procedure will also be refused if urine and blood tests show an inflammatory process in the body.
Immediately before the start of the study, the patient should completely empty the intestines and bladder. The gynecologist should tell about other restrictions at consultation.
Progress
Hydrotubation of the fallopian tubes 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 introduces a special solution through a syringe to which a pressure gauge is attached. The latter allows you to monitor the pressure. Its indicators should not exceed 200 mm RT. Art.
To check the patency of the fallopian tubes, physiological saline is administered. In especially serious cases, a contrast agent is added. Pipe flow allows you to evaluate the pressure gauge. In the absence of barriers to the flow of liquid, the pressure first decreases slightly, and then remains at the same level. With obstruction, this parameter gradually increases. In addition, after all the manipulations, saline will flow out.
The fluid supplied to the pelvis resolves independently. Additional action by the doctor is not required. After the diagnostic procedure, the patient is observed for some more time, after which they are released home.
Tubal obstruction may be partial. In this case, fluid enters the vagina after a few minutes or hours. If a pathological process is suspected, the doctor warns the woman in advance about possible discharge. The patient, in turn, must notify the doctor if such a situation occurs.
Hydrotubation
This procedure is also carried out for therapeutic purposes. The favorable period is the intermenstrual period. It usually takes about 5-6 manipulations over several cycles.
The technique of tubal tubing is practically no different from that when the procedure is prescribed for diagnostic purposes. However, instead of physiological saline, the following drugs are used:
- antibiotics (Penicillin, Streptomycin);
- corticosteroids to eliminate inflammation ("Hydrocortisone", "Prednisolone");
- for resorption of the adhesion process, "Lidase" is used;
- proteolytic enzymes with antimicrobial effect ("Trypsin").
The procedure is usually prescribed in conjunction with electrophoresis and gynecological massage. Throughout the treatment period, it is important to exclude sexual contact 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 patient’s health status, the presence of concomitant pathologies, and the body’s response to treatment.
Possible complications
Approximately 5% of patients are accompanied by complications of tubal tubing. Consequences of a negative nature are expressed in the following violations:
- temperature rise;
- spasm of the oviducts, accompanied by a painful syndrome;
- rupture of the fallopian tube against the background of the introduction of a large volume of fluid;
- allergy to the drugs used;
- exacerbation of inflammatory processes in the pelvic organs.
The most common complication is pain. It can be accompanied by pallor of the skin, respiratory failure and a decrease in heart rate.
Pregnancy after the 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 is 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 try to have a positive result.
After hydrotubation, most patients have a normal course of menstruation, restoration of the libido and the female cycle. If attempts to get pregnant fail, doctors recommend IVF. The procedure involves the fertilization of an 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 obstruction. It has some advantages when compared with other diagnostic options.
One of the main advantages is security. The technique does not imply the use of ionizing radiation, so it does not harm a woman’s body. If necessary, it can be repeated several times in a row.
Another advantage is the lack of need for hospitalization. After the manipulations, a woman can return to her business on the same day. The study is fast, and the results are immediately known. Tubal tubing is a relatively cheap and common procedure. Today, tools for its implementation are in almost every medical center.
Separately, it is necessary to mention the high accuracy and information content of this diagnostic method. In the standard version, the usual two-dimensional study is carried out, which does not allow to consider the fallopian tube completely. It bends in three planes. The solution to this problem is 3D and 4D ultrasound, with which you can build a three-dimensional image.
Medical statistics show that hydrotubation allows to obtain results that in 91% of cases coincide with laparoscopy. The reason for the discrepancies lies in the fact that ultrasound is an operator-dependent research method. Much depends on the qualifications of the specialist performing the procedure and his experience. In addition, extraneous factors also affect the quality of the ultrasound scan. We are talking about gases in the intestines, a high degree of obesity, etc.