The fallopian tubes connect the uterus to the ovaries. In them, the egg is fertilized and its further movement into the uterus for fixing 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 as planned. Surgery on the fallopian tubes is necessary for violations of their functions that threaten health or life, as well as anatomical abnormalities.
Most often, such an intervention is necessary when:
- Rupture of the tube as a result of an ectopic pregnancy. This is accompanied by profuse internal bleeding and can be life threatening. Therefore, removal of the fallopian tube during ectopic pregnancy is a necessary measure.
- An undisturbed ectopic pregnancy, when the situation cannot be corrected using conservative surgical therapy.
- Undisturbed, but repeated tubal pregnancy on the same side.
- Inflammatory processes of a chronic nature - purulent salpingitis, salpingoophoritis, hydrosalpinx on the left or right. Such pathologies have recently been not uncommon; their number is only growing from year to year. The early onset of sexual activity, sexually transmitted infections, abortions become the cause of 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 a pregnancy using reproductive technologies if infertility is diagnosed that is not amenable to conservative therapy, the cause of which is hydrosalpinx or chronic salpingitis. For example, with hydrosalpinx, fluid is collected in the fallopian tube, which has a toxic effect on the endometrium and the fertilized egg, and may even interfere with implantation, especially with exacerbation of the pathology. Pipe removal in this case is necessary in order to increase the efficiency 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 egg maturation and suppression of ovulation, therefore it is usually recommended for large tubes and if the hydrosalpinx on the left or right was found more than 6 months ago.
- Rupture of an ovarian cyst or twist its legs.
- The expressed adhesive process in which appendages are involved.
- Tubo-ovarian masses, large or multiple myomas, malignant tumors, external endometriosis, colon cancer. Often with such pathologies, the tube is removed with the remaining female organs.
- Gangrenous perforated appendicitis or Crohn's disease, which are accompanied by peritonitis, as a result of which appendages were involved in the pathological process.
The operation to remove the fallopian tubes is carried out laparotomically or laparoscopically.
Laparotomy intervention
This is abdominal surgery. 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 with adhesions in the pelvis, volume tumors 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. Indications for the use of this method are the same, but do not require emergency measures. An operation is also performed in this way, if it is not possible to carry out laparoscopy.
The operation on the fallopian tubes is carried out as follows:
- apply clamps to the uterine part of the tube and mesentery, which helps to stop bleeding (if any);
- dissect adhesions, if necessary;
- separating the pipe over the clamps, remove it.
If adhesions are absent, the abdominal cavity is not filled up with blood, then the operation lasts about forty minutes.
In some cases, instead of completely removing the pipes, they are partially excised. Such a procedure is possible if the patient:
- adhesions covered small areas;
- an ectopic pregnancy develops, but a rupture of the tube has not yet occurred;
- there is a small benign tumor in one of the segments of the uterus.
Laparoscopic surgery
It is carried out by introducing instruments into the abdominal cavity through three small incisions. During the intervention, a laparoscope is used, which looks like a flexible tube with a camera at the end. An image is displayed on the monitor, which makes it possible for the gynecologist to assess the condition of the reproductive organs, detect abnormalities and perform the operation.
Laparoscopic intervention is less traumatic. The recovery period after treatment does not last long and is easy.
Stages of the operation:
- Prepare the abdominal cavity. For this purpose, an incision is made in the area near the navel through which the 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 see the internal space.
- The needle is removed, replacing it with a laparoscope.
- Two more incisions are made into which the gynecologist surgeon inserts the instruments.
- After assessing the condition of the abdominal cavity and detecting a problem organ, clamps are placed, vessels are bandaged.
- Remove the fallopian tube.
- 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 contraindications to this type of removal of the fallopian tube. Laparoscopy is not performed if the patient has the following pathologies:
- Peritonitis.
- Rupture of the fallopian tube with heavy bleeding.
- Heart attack, stroke.
- Malignant diseases of the female genital organs.
- Obesity 3 or 4 degrees.
- Diabetes mellitus in the stage of decompensation.
In such cases, the laparotomy method is used to remove the tubes.
Any of the interventions is performed under general anesthesia. Laparoscopic salpingectomy requires the use of exclusively endotracheal anesthesia. Regional anesthesia (epidural or spinal) can be used if there is no bleeding.
Preparation for surgery
The patient is interested on what day to do a gynecological ultrasound, if there is an indication for surgery. Diagnosis is carried out immediately before surgery. In addition, a woman is taken blood for analysis, an abdominal cavity is also examined using ultrasound, and a chest radiograph is taken.
Proper preparation for the operation is important. For seven days before the procedure, the woman must adhere to a special diet. The day before the intervention, it is recommended to cleanse the intestines using an enema, while the use of food and liquid should be limited. Also, the patient carries out the necessary hygienic procedures, makes depilation in the bikini area.
Rehabilitation period
In order to recover faster after excision of the fallopian tube, early motor 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 easily digested and do not contain much fiber. There is no need for a special diet. At first, it is better to take liquid food, it is useful to use mashed soups, liquid cereals, and lactic acid products. If the intestines are not disturbed, nausea and vomiting are absent, steamed or boiled food is allowed. Fresh fruits, vegetables, flour products and sweets while it is desirable to avoid, as they contribute to increased gas formation. If during the operation a lot of blood was lost, it is necessary to include foods with a high content of vitamins, macro- and microelements in the diet.
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. Physical work will also have to be abandoned 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 health problems may occur.
In addition, restrictions are placed on sexual contacts. Sexual life is possible only after a month has passed after the operation. The main reason for this prohibition is the likelihood of infection entering the genital tract. Surgery 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 you begin sexual activity, it is advisable to visit a doctor. After the examination, the specialist will be able to say how the healing process goes, whether the infection has joined, or if other complications have arisen.
Postoperative therapy includes antibacterial drugs, anti-inflammatory drugs, vitamins. To prevent the occurrence of an inflammatory process, physiotherapy is recommended. Most often, ion and phonophoresis, laser and magnetotherapy are used.
To prevent the formation of adhesions are recommended:
- the introduction 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;
- the use of subcutaneous injections of aloe vera extract for two weeks, vaginal suppositories "Longidaza" may be prescribed;
- proper care of the seams to prevent inflammation (it is recommended to take a shower instead of the bath, covering the seam area to avoid water ingress);
- wearing tight underwear for a month after surgery.
After surgical treatment, a woman can observe the appearance of spotting from the vagina, which should not cause concern. This is due to the reflux of blood into the uterus during surgery.
Menstruation after removal of the fallopian tube may begin in a few days if recovery occurs quickly or there are any malfunctions at the hormonal level. This is also not cause for concern, if the nature of menstruation has not changed. With heavy bleeding, curettage may be necessary.
In the event that menstruation does not begin two months after the intervention, it is necessary to seek the advice of a gynecologist. Women's health requires attention, so you should not start 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 an increase in temperature, which indicates the development of inflammation.
- Bleeding, hematomas in the abdominal cavity. Such violations indicate that the coagulation of the patient is impaired or the hemostasis procedure was carried out incorrectly.
- The appearance of nausea and vomiting. Such signs can occur as a reaction to the introduction of anesthesia, and the cause may be irritation of the intestine after laparoscopic surgery with the introduction of carbon dioxide into the abdominal cavity.
- Adhesions that interfere with the work of internal organs. The possibility of their occurrence exists after an operation performed in any way. A sign of adhesions will be pain after the procedure. In the future, adhesions can affect the intestines, which will affect its patency.
It should be noted that such complications do not occur so often.
Effects on the body
According to many gynecological surgeons, the fallopian tubes are necessary only so that the egg can pass through them, and surgical intervention in this area does not affect the state of the body as a whole.
But scientific research proves something else, because the uterus with tubes and ovaries is a single system. So, almost half of the patients who underwent surgery may develop symptoms after a while, indicating violations in the activity of the neuroendocrine system. These signs include:
- the appearance of excess weight;
- excessive hair growth;
- malfunctioning of the thyroid gland;
- soreness and engorgement of the chest.
The consequences of the removal of the fallopian tubes for the body may be different. Women who underwent surgery note that they often began to increase blood pressure, headaches and dizziness appeared. Also, patients are tormented by flushes of heat and excessive sweating, increased emotionality, instability of the psyche, heart palpitations. Such manifestations begin to occur after a long delay in menstruation, and this phenomenon is observed in approximately 30% of the fair sex who underwent removal of the fallopian tubes. The consequences for the body begin to appear a few months after the intervention, malfunctions of the menstrual cycle occur, ovulation may be absent, the functions of the follicles and corpus luteum decrease.
After conducting an instrumental study, it is possible to detect a violation of 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 pipes, all of the listed symptoms will be more pronounced, while there is a risk of an early onset of menopause.
Can I get pregnant after removing the fallopian tube
The only opportunity to have a baby after bilateral pipe removal is IVF. If only one tube is preserved, approximately 60% of women undergoing surgery have a chance of natural fertilization and pregnancy.
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. Diagnostic results will help to understand whether a successful pregnancy is possible. Also, a woman will need to take a biochemical blood test and for infections, a urine test, swabs from the genitals, and 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 5-8 day of the cycle. Both spouses will also need to be tested for HIV and hepatitis.
If the health status of the spouses is not a concern, preparation for fertilization will consist in protecting the expectant mother from stress, colds and other diseases, obtaining vitamins and minerals necessary for the body from food or using multivitamin complexes.
When can I plan a pregnancy?
Pregnancy planning can be done no earlier than six months after the intervention. Best if 12 months pass. Until then, it is necessary to use oral contraceptives. Such drugs allow you to relax your ovaries, help avoid undesirable during this period of conception, restore the tone of the remaining fallopian tube. Also, oral contraceptives contribute to the normalization of the hormonal background, and this is very important for the onset and subsequent successful bearing of the child, even if only one fallopian tube remains.
After the cancellation of hormonal drugs, a couple can begin an active intimate life and not be protected. For the onset of pregnancy, it may take from 6 months to a year, which is a variant of the norm.
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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, restoration is not possible.
To prevent serious complications of 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, this measure even helps to get pregnant, even with the help of in vitro fertilization.