With a violation of the patency of the fallopian tubes, vivid symptoms are not noted, and a woman may not be aware of a developing problem for a long time. Well-being is not broken in any way, the duration and nature of menstruation also does not change, cycle failures are not observed. It does not matter which fallopian tube is impassable. Even blocking one of them can lead to infertility.
Signs
An important and obvious sign indicating the appearance of obstruction of the uterus is the inability of a woman to become pregnant, even with regular sex without any means of protection.
Given the cause of the obstruction, its clinical presentation may also vary.
If the cause of clogging of the tubes is an adhesive disease due to inflammation of the reproductive organs, the patient is worried about the painful, aching sensations in the lower abdomen.
If obstruction develops after surgery, then the pain is likely to be pulling. Sometimes it becomes very intense, disrupting the quality of life. A woman may have pain during sexual contact, when the vagina is stretched.
A symptom that makes it possible to determine clogging of the tubes is severe pain during a normal menstrual cycle.
Common symptoms
So, we determine the most likely symptoms of obstruction of the tubes of the uterus:
- Painful sensations during menstruation. Periodically arising pains of aching or pulling character in the lower abdomen.
- Unpleasant sensations during sexual intercourse.
- Pathological discharge from the vagina.
Reasons for clogging
Tubal obstruction is a big problem for a woman's body.
There are several reasons for clogging the 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);
- abortion, ectopic pregnancy;
- myoma;
- commissures;
- abdominal surgery.
Why can't you get rid?
The reasons why it is impossible to get rid of the obstruction of the fallopian tubes are different:
- The most common is the age of the woman (35 years and above).
- The presence of inflammation of the genitourinary organs and inflammatory processes of the organs of the reproductive system.
- Genital tuberculosis.
- Accumulation of fluid in the lumen of the pipes.
- Commissures.
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 to test fallopian tubes for patency?
For diagnosis, several methods are used. Among them:
- Ultrasound of the fallopian tubes is a modern affordable diagnostic method that allows you to identify diseases of the female reproductive system, such as abnormalities in the structure of organs, the presence of inflammation, adhesions and tumors.
- Echo hysterosalpingography or hydrosonography is a diagnostic procedure, which is the introduction of sterile saline into the cervix and the passage of fluid through the fallopian tubes using an ultrasound probe.
- Hysterosalpingography, or metrosalpingography, is the main and most informative diagnostic method, its effectiveness is up to 98%. The study consists in introducing a contrast medium through a special catheter into the uterine cavity and performing a series of x-ray images with which you can evaluate the shape and structure of the uterus, as well as the condition and patency of the fallopian tubes. As a contrast agent , water-soluble radiopaque agents are used - Cardiotrust, 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.
- Tubal perturbation or “purging” is a study in which an obstetrician-gynecologist introduces oxygen into the cervix using a special apparatus. If the gas freely passes into the abdominal cavity through the pipes, the pressure gauge installed in the device will indicate a pressure drop in them. In the case when there is obstruction, air will accumulate in the uterus, and this will be displayed by 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 clavicle of the patient.
- Chromotubation laparoscopy 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 to assess the condition of the pelvic organs and perform the necessary manipulations. The operation can be supplemented with chromotubation - the introduction of sterile colored fluid into the uterine cavity and the assessment of fluid passage through the tubes.
- Fertiloscopy or transvaginal hydrolaparoscopy - this procedure is more easily tolerated by women and is performed under local anesthesia in the outpatient clinic. Unlike the previous technique, access is not through the abdominal wall, but through the back of the vagina.
Before diagnosis, you need to consult a doctor, only he can prescribe the necessary procedure after a thorough examination of a woman. The examination should begin with accessible and minimally invasive studies and only if necessary, switch to surgical diagnostic techniques.
Recovery Methods
For the treatment of tubal obstruction, various conservative and surgical methods of therapy are used.
The most effective method in modern gynecology is surgery, the most common of them - laparoscopy, fertiloscopy, hydrotubation, recanalization.
Most often, the first two types of manipulations are used: laparoscopy of the fallopian tubes 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, exempt from adhesion synechia.
- Salpingo-salpingoanastomosis - a section of the pipe 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 is the dissection of adhesions of the fallopian tube. With a successful outcome of the surgical intervention, pregnancy can occur within a few months.
- Tubal ligation is used to prevent proliferation of tubal obstruction.
Fertiloscopy
Fertiloscopy is the second method of surgical treatment using endoscopic and laparoscopic instruments. Fertiloscopy is considered more gentle, as access to the female reproductive organs is carried out through the back wall of the vagina. Using the optical system, a thorough examination of the fallopian tubes is performed, 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 feeding 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 during 1-5 menstrual cycles. This treatment method is considered obsolete in many clinics, but in some cases, for example, if there are contraindications for surgical treatment, it is successfully used.
Recanalization
Recanalization is another type of treatment for pathology. Effective with a slightly pronounced adhesive process and the preferred 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 promoting the catheter along the lumen of the fallopian tube, pumps air in the balloon, thereby straightening it and eliminating obstruction. After treatment, regardless of the method chosen, patients are prescribed anti-inflammatory and anti-adhesion therapy.
Complete obstruction
100% obstruction of the tubes of the uterus can be treated only if their structure is not damaged much or if adhesions are located outside the appendages. Also, treatment can be started in the absence of a woman's acute inflammatory processes. It is noteworthy that after the procedure for restoring 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 push the fertilized egg deeper into the uterus. If this is not achieved, there is a risk of an ectopic pregnancy.
It will not work to get rid of the problem in such cases:
- the presence of an inflammatory process in the genitourinary organs;
- the patient's age is more than 35 years;
- genital tuberculosis;
- frequent exacerbations of inflammation;
- detected hydrosalpinx, which is large;
- a large number of adhesions in the abdomen, which fuse organs together;
- adhesions in the inner part of the fallopian tubes.
It is important to take into account that after normalization of the patency of the tubes of the uterus, it is impossible to 100% guarantee full work!
ECO
When diagnosing the diagnosis of "obstruction of the fallopian tubes" in women, in vitro fertilization is possible. It will be justified after the treatment of chronic diseases of the genital area. Obligatory full treatment of infection up to removal of the uterine tubes gives prospects for positive results.
Removal of the fallopian tubes can be a popular method with a large deformity 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 chances of restoring pipe patency.
- It is impossible to completely eliminate the inflammatory disease.
In vitro fertilization with obstruction of the tubes - the choice of women for the following reasons:
- With complete obstruction of the fallopian tubes, it becomes more difficult to get pregnant and bear a child.
- 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, the chance of conception will be reduced to 20%.
- IVF procedure in 65% of cases will help women with a low chance of conception before the age of 35 get pregnant. In such cases, IVF should not be refused.
- With obstruction of the fallopian tubes, the risk of an ectopic pregnancy increases. During the IVF procedure, it decreases to 2%.
- Learn about the results of IVF becomes possible in ten days.
Folk remedies
In the treatment of fallopian tubes, the following agents are used:
- Psyllium seeds It is necessary to prepare a medicinal decoction from the plant: a glass of water is heated, 1 tablespoon is added. plantain seed. After this, the broth is aged for half an hour in a water bath and filtered. The broth is used 4 r / d. 2 tbsp. before meals. To get rid of obstruction of the tubes of the uterus, drink a decoction of 60 days.
- 1 tbsp of grushanka is added to 1 tbsp. boiling water and aged 40 minutes in a steam bath. The broth cools, boiled water is brought to a volume of 250 ml. Means to use 3 r./d. 1/3 cup each.
- Healing tincture can also be used to make a healing tincture: 500 ml of vodka is poured into 2 packs of the plant, after which the infusion is left, periodically shaking. After 18 days, the infusion is filtered and taken before meals, 25 drops for 3-6 months.
- Burdock juice. Only young leaves with petioles are taken. Raw materials are selected mainly in May-June. The leaves are washed and soaked for 2-3 hours in water. After that, they should be dried and chopped in a meat grinder. Squeeze the juice out of the pulp and consume 1-2 tablespoons a week. juice 3 r / d Then they take a week break, after which they repeat the scheme. It is not recommended to drink a dose of burdock juice with water, if the juice is bitter, mix with honey.