To methods of checking patency fallopian tubes include the following: hysterosalpingography (metrosalpingography), echo-hysterosalpingoscopy (sonosalpingography), pneumopertubation, hydropertubation, office hysteroscopy, diagnostic laparoscopy. These studies vary in complexity, safety, reliability and cost. The most common is hysterosalpingography.
Checking the patency of the fallopian tubes using hysterosalpingography
The study of fallopian tube patency using hysterosalpingography is carried out on a special radiolucent chair. During the procedure, the following manipulations are performed. A rubber tip is inserted into the cervical canal, through which a thin tube (cannula) passes. The rays of an X-ray machine are directed onto the pubic area. A small amount is injected into the uterus contrast agent and take the first shot. Then a little more contrast agent is injected, which then enters the tubes, and another picture is taken. In this case, signs of obstruction of the fallopian tubes are clearly visible. If a woman is allergic to the contrast agent, air is injected instead. This study allows us to detect dilation and tortuosity of the fallopian tubes. The disadvantages of this procedure include quite severe discomfort during its implementation.
Other methods for checking the patency of the fallopian tubes
Sonosalpingography is less informative, but more gentle. In this case, ultrasound is used instead of X-rays, and instead of a contrast agent - saline solution. Office hysteroscopy carried out with the help special tool- a hysteroscope, at the end of which there is a camera. It is inserted through the vagina into the uterus, which is then examined. They also check the condition cervical canal, pipes Hydro- and pneumopertubation are now rarely used, since these studies are believed to stretch the tubes. The essence of the last two methods is to introduce a solution or air under pressure into the uterus.
The most informative study is laparoscopy. Its advantage is the ability to immediately eliminate the pathology. A common cause of tubal obstruction is adhesions that appear due to endometriosis, inflammation, and surgery. They can be removed during laparoscopy. This procedure is carried out under general anesthesia. Three small incisions are made in the abdomen through which an instrument and a camera are inserted to allow examination of the internal organs. After the operation, the patient must remain in the hospital for at least 24 hours.
The uterine (fallopian) tubes are paired organ, located in the pelvic cavity. One end of it is adjacent to the uterus, and the other is located in close proximity to the ovary. It is not attached to the ovary, so women who have only one fallopian tube left have a chance of conceiving even if ovulation occurred in the ovary on the opposite side.
A mature egg breaks through the capsule dominant follicle and extends beyond the ovary. With the help of a chemical signal, it is attracted to the funnel of the fallopian tube and begins to move along it towards the uterus.
If at this moment there are viable sperm nearby, then one of them has a chance of fertilization. Thus, the fallopian tube performs the function of transporting the egg and sperm for their fusion, and then the fertilized egg for its entry into the uterus.
In the absence of pipes or obstruction independent pregnancy is impossible, even if the ovaries consistently produce eggs every month, but how to check the patency of the fallopian tubes?
Indications for testing
The procedure for checking the patency of the fallopian tubes requires special preparation and, in addition, it is very painful. Therefore, the indication for diagnostic procedures may be the absence of pregnancy, when all other tests are normal and the gynecologist has not identified any obstacles to conception. A fallopian tube clogged with adhesions is unable to function normally.
This means that either the sperm is unable to reach the egg, or the fertilized egg is unable to descend into the uterus. Both have very serious consequences:
- – in this case occurs due to mechanical obstacles. The obstruction may be partial, but even then it often happens that the sperm can penetrate the cavity of the fallopian tube, but the egg cannot, because it is much larger and the adhesions do not allow it to move freely.
- - occurs due to the fact that the fertilized egg is not able to penetrate the uterus and is forced to implant itself in the wall of the fallopian tube. This is the most serious complication caused by adhesions and obstruction.
Every year in Russia 0.4% of women from total number pregnant women die as a result ectopic pregnancy.
Causes of fallopian tube obstruction
Treatment will directly depend on what caused the problem. Narrowing of the lumen of the fallopian tubes or its complete absence may be both a consequence of their internal blockage and the result of compression from the outside. Gynecologists identify several factors that may cause complete or partial obstruction:
- Adhesions formed as a result of STDs.
- Adhesions formed after inflammation of the ovaries, urethra, uterus or cervical canal.
- Polyps blocking the entrance to the fallopian tube.
- Disruption of the functions of microvilli, with the help of which the fertilized egg descends down to the uterus.
- Compression of the fallopian tubes by internal organs that initially had an incorrect anatomical position, or took it as a result of prolapse or surgery.
- Mechanical damage to the mucous membrane of the tube cavity as a result of surgical interventions.
- Congenital anomalies of organ development reproductive system.
Sometimes the cause of obstruction is difficult to determine through diagnostic procedures. In these cases, laparoscopy is prescribed, which is considered the most informative.
Types of obstruction
After testing for tubal patency, the doctor will determine the type of disease. Further correction of the adhesive process will occur in accordance with how extensive its localization is.
By type of prevalence pathological changes There are two types of obstruction of the fallopian tubes:
- One-sided - involves disruption of the functioning of one oviduct. In this case, a woman has a chance of conceiving if ovulation occurs in the ovary to which a healthy tube is adjacent. There are cases when pregnancy resulted from the entry of an egg into a healthy oviduct from the opposite ovary.
- Bilateral – involves disruption of the functioning of the oviducts on both sides. In this case, it is impossible to get pregnant on your own, so the only opportunity to become a mother will be to use the IVF or ICSI method.
Degrees of obstruction
The adhesive process or compression of the fallopian tube by internal organs can have different effects on the degree of narrowing of its lumen. There are two forms of obstruction:
- Partial obstruction - there is a lumen in the tube, but it is so small that a fertilized egg cannot always descend into the uterus. This degree of obstruction is the most dangerous in terms of the occurrence of ectopic pregnancy.
- Complete obstruction - the lumen in the tube is not visible, the organ is completely blocked by the adhesive process and cannot even ensure the fusion of sperm and egg.
Localization of the adhesive process
The fallopian tube has various departments, therefore they can accumulate and affect the narrowing of the lumen in different places this organ of the reproductive system.
The oviduct consists of an interstitial section, which is located near the lateral edge of the uterus, an isthmus, an ampulla (long part), and a funnel that opens into abdominal cavity. Accordingly, the localization of the adhesive process can be at any of these levels:
- Intramural obstruction - blockage of the fallopian tube occurs in the place where it is adjacent to the uterus.
- Isthmus obstruction - blockage is observed in the narrowed section of the tube closest to the uterus.
- Obstruction of the tortuous section - accumulation of adhesions is observed in the longest part of the pipe.
- Infundibulum obstruction - adhesions are diagnosed in that part of the tube that is located in close proximity to the ovary and receives a mature egg.
According to the observations of specialists, most cases of obstruction are recorded in the tortuous section of the oviduct. The least is in the funnel area.
Often, a woman does not even realize that the functioning of the organs of her reproductive system is impaired. But it is impossible to check for obstruction of the fallopian tubes at home, so you need to consult a doctor who will choose the most appropriate diagnostic method.
A conventional ultrasound will not be able to provide a complete picture of pathological changes in the fallopian tubes, so it is necessary to resort to endoscopic testing methods and methods that involve filling the cavity of the tubes with a contrast agent.
These procedures are quite painful, and some of them require the patient to be put under anesthesia. Let us consider in detail how the patency of the fallopian tubes is checked.
Studies using contrast media
- Hysterosalpingography (HSG)
The study is carried out using x-rays, is painful and involves filling the fallopian tubes with a special solution. Among the most commonly used are cardiotrust, triombrast, urotrast, verografin.
Preparation for the procedure: do an enema, empty bladder, perform hair removal on the genitals.
Carrying out the procedure: the patient is placed on a special table in such a way that x-ray passed through top edge womb. First you need to obtain a relief image of the contours of the uterus. To do this, 3 ml of contrast agent is injected and an image is taken.
Then an additional 4 ml of contrast agent is injected so that the uterus is filled - this manipulation provokes fluid to pour into the fallopian tubes, and from there, if they are patency, into the abdominal cavity. After this, a second photo is taken.
Interpretation of results: The fallopian tubes are considered to be well patent if the contrast agent flows into the abdominal cavity over a long distance.
- Echohysterosalpingography (Echo-HSG)
You can examine the patency of the fallopian tubes using ultrasound. The procedure also involves the use of liquid, but in this case, not a contrast agent is injected, as with HSG, but saline solution (sodium chloride).
Another feature of this method is that it is carried out only in the first phase menstrual cycle.
Preparation for the procedure: you need to do an enema, drink half a liter of liquid and epilate your pubic hair.
Carrying out the procedure: A saline solution is injected into the uterus through a catheter, which fills it completely and pours into the cavities of both tubes. After this, the doctor begins to conduct ultrasound monitoring with a vaginal sensor every 3-4 minutes. As a result, it is possible to detect areas of the oviduct whose lumen is narrowed or completely blocked.
Interpretation of results: when the tubes are completely patency, the solution will flow freely into the abdominal cavity.
Endoscopic examination
- Office and surgical hysteroscopy
It involves inserting a hysterosocope (camera) into the uterine cavity, the image from which is displayed on the monitor. There are two types of this procedure: office, performed under local anesthesia V diagnostic purposes, and surgical, performed under general anesthesia. Hysteroscopy is performed on days 5-7 of the menstrual cycle.
Preparation for the procedure: empty your bladder and remove hair from the intimate area.
Carrying out the procedure: A hysteroscope is inserted into the uterine cavity. It is designed in such a way that it allows you to simultaneously take pictures and supply fluid with which the body of the uterus is filled. The monitor displays not only an image of the inner layer of the uterus, but also the cavity at the mouth of the fallopian tubes.
- Laparoscopy
The procedure is performed only under general anesthesia. It is a surgical intervention in the abdominal cavity, which simultaneously performs both diagnostic and therapeutic functions.
Preparation for the procedure: The patient should empty her bladder and shave her pubic hair.
Carrying out the procedure: after administration of anesthesia in the anterior abdominal wall the doctor makes 3-4 punctures. They are needed to insert a mini-camera and the necessary surgical instruments. For expansion abdominal space Carbon dioxide is supplied through the navel area.
If laparoscopy is diagnostic in nature, then the operation lasts 20-30 minutes. If the surgeon decides to remove adhesions or other obstructions that block the lumen of the fallopian tube, the operation time will increase.
Consequences of checking the patency of the fallopian tubes
Checking the patency of the fallopian tubes is one of the most troublesome procedures in the list of examinations for female infertility. However, in order to avoid the risk of ectopic pregnancy, you should not delay your visit to the doctor and do not try to treat the adhesions yourself.
There are usually no consequences for checking the patency of the fallopian tubes. Only procedures carried out without observing the rules of antisepsis and asepsis can cause inflammatory processes in the pelvis.
Assessing the condition of a woman's fallopian tubes is important stage examinations for infertility.
Let's try to figure out when it is necessary to check the fallopian tubes and what methods exist for assessing the condition of the fallopian tubes.
Question one: when to check the fallopian tubes?
The fallopian tubes should be checked after assessing the spouse's ejaculate, that is, if male reasons infertility in marriage.
If the spouse has poor sperm quality and the situation does not change after the man’s treatment, there is no point in checking the tubes; this will be an unnecessary intervention in the woman’s body (for which you will still have to pay).
How to check the fallopian tubes?
Before answering this question, let's look at the role of the fallopian tubes in conception.
Normal wide part The fallopian tube is located next to the ovary. And at the moment of ovulation, this contact becomes closer - the tube literally captures the area of the ovary where the follicle ruptured (ovulation) and the egg immediately enters the fallopian tube.
If there are sperm in the fallopian tube (sexual intercourse at the time of ovulation or the day before), then they reach the egg and normally one sperm penetrates it - fertilization occurs.
During the division process, the embryo moves through the tube towards the uterus. But the embryo itself cannot move - it is propelled by the fallopian tube, thanks to peristalsis and the movement of microvilli that line the tube from the inside.
Thus, for pregnancy to occur, three characteristics of the fallopian tubes are important - they must be passable, have good physical activity and be in close contact with “your” ovary. The figure clearly shows the contact of the fallopian tube with the ovary during the process of ovulation.
Now let's talk directly about methods for assessing the condition of the fallopian tubes.
The first method is the simplest, but the least informative, that is, inaccurate. This metrosalpingography/hysterosalpingography or a photo of the fallopian tubes.
The essence of the method is that a radiopaque substance is injected into the uterine cavity. The contrast fills the uterus, fallopian tubes, and if it flows out of the fallopian tubes, they are passable. If the contrast does not flow out, the pipes are impassable.
The sensitivity of this method (that is, how often the method shows the pathology that is there) is about 60-70%. Thus, in 30-40% of cases, a woman may have problems in the pelvis (adhesions that “disconnect” the fallopian tube and ovary; endometriosis), but the picture will be normal.
Therefore, modern medicine gives preference endoscopic methods diagnostics, that is, direct visualization methods internal organs. This is a TGL procedure and laparoscopic surgery.
- wonderful, modern method assessment of the condition of the fallopian tubes.
The essence of the method is that a thin video camera is inserted through the back wall of the vagina and enters the pelvic cavity. An image of the organs (uterus, ovaries and fallopian tubes) is displayed on the monitor. We evaluate the condition of the fallopian tubes and ovaries, and check the patency of the tubes.
In this case, the procedure is carried out under local anesthesia and the woman (if desired) can “look at herself from the inside.” The only “disadvantage” of the method is that it is diagnostic, that is, if we find a problem (for example, adhesions), surgery is required to eliminate it - laparoscopy. In this case, it is possible to perform the operation immediately after TGL - the woman is given anesthesia and laparoscopy is performed.
And finally, laparoscopy- is the “gold” standard for diagnosis and treatment female infertility. This is not only a way to determine the cause of a woman’s lack of pregnancy (adhesions, cysts, endometriosis), but also to eliminate it.
Laparoscopy has many advantages compared to traditional incision surgery: cosmetic effect(no scars), hospitalization 1-2 days, reduction of postoperative pain, fast recovery performance and others.
What determines the choice of method for assessing the condition of the fallopian tubes?
The main role in this issue is given to the woman’s medical history - that is, we take everything into account previous diseases(including infections), surgical interventions.
Checking the patency of the fallopian tubes is one of the first diagnostic measures in identifying the causes of infertility. After all, medical statistics claim that obstruction of the fallopian tubes is the cause of almost half of all cases of infertility. Let's take a closer look at the features of this procedure.
The fallopian tubes (oviducts, fallopian tubes) are two thin tubes that connect the uterus to the ovaries. It is through them that the egg enters the uterus. But if there are adhesions in the tubes, spasms or tumors occur, the egg cannot reach its destination and conception does not occur.
Methods for checking the fallopian tubes: preparation, implementation and interpretation of the results
Is it difficult to diagnose tubal obstruction? For modern medicine this is not a particular problem. Thanks to the development of new and improvement of old diagnostic methods, doctors can accurately determine the causes of infertility. The reliability of methods for checking the fallopian tubes is 80-90%, and if the doctor is not sure of the result, a repeat examination will help eliminate all doubts.
Before diagnosing the condition of the fallopian tubes, it is necessary to undergo a routine gynecological examination, as well as a series of tests: a smear to determine the flora, a blood test for HIV, syphilis, hepatitis B and C. Only after this the doctor usually prescribes one of the following diagnostic examinations.
Hysterosalpingography
Hysterosalpingography, or HSG, is an X-ray examination of the uterus and fallopian tubes with contrast. The contrast agent is injected into the uterus through a special thin tube - a cannula. It fills the uterus and moves through the fallopian tubes. The substance is clearly visible on x-rays, and by how the contrast spreads in the cavities, the doctor assesses the condition of the oviducts and inner surface uterus. This method gives very clear images in which the specialist can see adhesions and other pathologies: fibroids, polyps or synechiae in the uterine cavity, hydrosalpinx and peritubular adhesions (that is, adhesions pressing on the fallopian tube from the outside). The results of this examination are accurate in approximately 80% of cases, and if the doctor has doubts, he may prescribe additional research another method.
Hysterosalpingography can be performed only in the absence of inflammation, so before the examination you should be tested for HIV, hepatitis B and C, syphilis and a smear for flora. Pregnancy is also a contraindication. HSG is performed without anesthesia, it is relatively painless (only some patients report some nagging pain lower abdomen during contrast administration). The radiation dose for HSG is very low, but doctors strongly recommend not planning conception for 2-3 weeks after the examination. Usually this procedure is carried out no later than the 14th day of the menstrual cycle, but in some cases - after ovulation.
Hydrosonography
This method involves performing an ultrasound. After the usual gynecological examination the doctor, under the supervision of a sonologist, injects a sterile saline solution into the uterine cavity. At this moment, both the uterus itself and the fallopian tubes are very clearly visible on the screen. Thus, this method is very similar to hysterosalpingography, but the patient does not receive radiation. Therefore, with almost equal information content, ultrasound with contrast is considered safer. The hydrosonography procedure is recommended to be performed before the 9th day of the menstrual cycle, when the endometrium is thinnest and the doctor can examine the uterine cavity in as much detail as possible.
The procedure takes 20-40 minutes, does not require special preparation (other than routine tests for STDs and pregnancy) and is well tolerated. The injected liquid is quickly absorbed by the peritoneum. Hydrosonography is often prescribed instead of HSG in cases where a woman is allergic to the contrast agent (usually it contains iodine).
Diagnostic laparoscopy and fertiloscopy
When conducting a laparoscopic examination of the patency of the fallopian tubes, the doctor makes small incisions on the abdominal wall and inserts through them optical instruments to assess the condition of the inner surface of the fallopian tubes. One of the types of diagnostic laparoscopy is fertiloscopy - the introduction of fluid into the pelvic area through a puncture back wall vagina and subsequent examination of the tubes using an endoscope. The liquid allows for better visualization of adhesions.
The punctures during diagnostic laparoscopy are very small, they leave no scars, but the operation, of course, is performed under anesthesia. Laparoscopy is one of the most precise methods diagnosis of fallopian tube obstruction. With its help, you can not only detect obstruction, but also find out what is causing it - adhesions or spasms. Usually the operation is well tolerated, but just in case, the patient should spend a day in the hospital, and can return to normal life after 2-3 days. However, you will have to give up trying to conceive for 2-3 weeks.
This is important
The most common reason obstruction of the fallopian tubes – past inflammation caused by infections. Usually the culprit of such problems is chlamydia, which many consider relatively harmless disease. It is really easy to cure, but this must be done on time, since the causative agent of chlamydia quickly spreads and penetrates deeply into the tissue of the fallopian tubes, damaging the mucous membrane, causing fibrosis and very active adhesions not only in the pelvis, but also in the abdominal cavity, and even around the liver.
Pertrubation
Perturbation is called blowing of the fallopian tubes. During this diagnostic procedure Air is introduced into the uterine cavity, and special equipment records its pressure. Before the procedure, you must do a cleansing enema and empty your bladder. Perturbation is not performed after certain gynecological manipulations that can cause tubal spasm, otherwise the results will be inaccurate. In other cases it is quite informative method diagnosis of fallopian tube obstruction.
What is the best way to assess patency?
All methods for diagnosing fallopian tubes are equally reliable, but there are differences between them.
HSG exerts a certain radiation load on a woman’s body, but this method is informative and convenient - after the study, the patient receives pictures that her attending physician can use to make a diagnosis, even if she decides to be treated in another clinic. However, the contrast used during the examination contains iodine, a fairly common allergen. Therefore, if there is a risk of an allergic reaction, ultrasound is not prescribed. Hydrosonography is safe, but often it is impossible to record the results of the examination - only the most modern equipment allows this to be done. The examination takes place in real time, and the patient receives only a medical report.
Laparoscopic methods Rarely used as the very first examination, they are resorted to only in cases where other diagnostic methods have proven powerless.
Perturbation is used infrequently these days, since the reliability of this method, although very little, is lower than that of other diagnostic methods.
The method for determining the patency of the fallopian tubes is prescribed by the doctor, who takes into account many indicators, including age and general condition health, test results and previous diagnostic procedures.
Tuesday, 04/10/2018
Editorial opinion
Most women suffering from blocked fallopian tubes are unaware of this pathology until they decide to become pregnant. Tubal obstruction develops unnoticed and in most cases asymptomatic. Nevertheless, it is very dangerous - adhesions in the tubes lead not only to infertility, but also to ectopic pregnancies.
From 20 to 60% of infertile couples face the problem of fallopian tube obstruction. These areas are the thinnest tubes with a diameter of 0.1 to 1 mm. in different segments. Modern medicine offers different options how to check the patency of the fallopian tubes. One or the other method is chosen individually. When choosing a method, obstetricians-gynecologists take into account the patient’s medical history and personal wishes.
It is recommended to check the patency of the tubes for all women who are unsuccessfully planning a pregnancy for more than one year. However, this manipulation does not always come to pass. Doctors usually start with a simpler diagnosis, which allows them to find out the reason for the lack of pregnancy.
For infertility unknown origin as a result of determining the patency of the fallopian tubes, adhesions may be detected on different areas. not visible during normal ultrasound examination, so it can be difficult to establish their presence. The causes of tubal infertility can be diseases of the pelvic organs or instrumental interventions. Therefore, the study is prescribed to the patient if the lack of pregnancy is associated with the following factors:
- previously conducted surgical interventions on the abdominal cavity;
- instrumental manipulations in the uterus;
- inflammation of the pelvic organs, especially chronic;
- anatomically modified oviducts;
- neoplasms in the fallopian tubes;
- endometriosis;
- history of ectopic pregnancy.
Diagnosis tubal infertility"Only passability checks can be performed. In this case, it is important to consider in which segment the obstruction is detected, whether the pathology is unilateral or bilateral, and whether there are chances for successful restoration of the functionality of the fallopian canals.
How to determine the patency of the fallopian tubes
All methods of checking the patency of the fallopian tubes require preliminary preparation. All procedures are performed in a hospital. Hospitalization is not required in all cases. Usually, after the procedure, the girl is allowed to go home. The exception is laparoscopy and fertiloscopy. Each manipulation has its pros and cons. It is important to follow your doctor's recommendations after diagnosis.
The method by which the examination will be performed is selected in accordance with the indications and obstetric history. At high probability if the tubes are obstructed (after an ectopic pregnancy or surgery), it would be preferable surgical method allowing immediate treatment. If the likelihood of pathology is minimal, then a more gentle method is chosen.
Hysterosalpingography - HSG
X-ray of the tubes begins with the patient being given an injection of an antispasmodic within 30-60 minutes, and they can also use anticholinergic drugs for individual indications. After this, the woman sits on a couch under an X-ray machine. Using a thin catheter, a contrast solution is injected into the uterine cavity. When a substance fills an organ, it rushes into the pipes. At this moment the device takes a photo. If the image shows that the solution has entered the abdominal cavity on both sides, then the pipes are passable. Fluoroscopy may show that the contrast agent has passed through the tube on only one side. In this case, it is determined on which section on the other it stopped.
When a patient undergoes HSG, it is quite unpleasant for her. To reduce discomfort, doctors recommend relaxing as much as possible. Tension and contraction of the pelvic muscles can distort diagnostic results.
At good performance After checking the patency of the fallopian tubes, it is recommended to plan pregnancy only after a month to exclude negative influence x-ray on germ cells.
If you check the patency of the fallopian tubes without a preliminary examination, the consequence of the procedure may be infection of the appendages, an allergic reaction or injury.
Hydrosonography (Echohysterosalpingography)
Hydrosonography is a diagnostic procedure that involves the administration of a saline solution instead of a contrast solution and the use of an ultrasound machine instead of an X-ray. This procedure is preferable for patients who have allergic reaction for iodine or disease thyroid gland. The advantage of diagnostics is the lack of radiation, but the disadvantages include low information content.
Before performing Echo-HSG, the patient must undergo a smear for infections, and also make sure there is no pregnancy. The examination does not cause pain, but to facilitate the insertion of the catheter, it is recommended to be carried out on days 10-13 of the cycle, when the cervix expands under the influence of hormonal levels.
A saline solution is injected into the uterine cavity through a thin tube. At this time, the sonologist installs the ultrasound machine sensor on bottom part abdomen and observes the behavior of the fallopian tubes. The result is assessed as in the previous case: if the solution has entered the abdominal cavity, then the pipes are passable; If it doesn’t work out, then you can make a diagnosis of “tubal infertility.”
Metrosalpingography – MSG
A modern procedure for checking the patency of the fallopian tubes is selective metrosalpingography. The main advantage of the manipulation is that recanalization can be performed simultaneously. If adhesions in the pipes are detected in certain areas, they are “broken” with a solution that is supplied under pressure.
Before performing the diagnosis, the patient must undergo a smear to determine the cleanliness of the vagina and a blood test. The manipulation is carried out using an X-ray machine. A catheter is inserted into the uterine cavity, the mouth of which comes as close as possible to the fallopian tube. The study allows us to minimize negative action contrast agent on the mucosa reproductive organ. The results of the study are presented in the form of images, as with HSG.
Laparoscopy
Diagnosis of fallopian tube patency is performed using endoscopic examination– laparoscopy. The disadvantages of the procedure include the need for anesthesia and hospitalization. The advantage of laparoscopy is the ability to restore patency of the fallopian tubes immediately.
The operation involves more extensive preparation. The woman is prescribed blood tests, urine tests, and various vaginal smears. An enema is performed before the intervention, and on the day of the procedure it is forbidden to consume food and water. With the help general anesthesia the patient falls into a sleep state. The examination is carried out through 3-4 small incisions or punctures in the peritoneal cavity. If during the operation the surgeon is convinced that tubes are necessary, then diagnostic laparoscopy becomes therapeutic. The doctor removes adhesions in the tubes.
Fertiloscopy
An alternative to laparoscopy has become modern analysis tubal patency, which can also determine other pathologies of the pelvic organs. Fertiloscopy involves making an incision in the posterior vaginal vault and inserting optical instruments. The intestinal loops are elevated by filling the peritoneum with saline.
In preparation for the procedure, all tests required by laparoscopy are taken. As a result of fertiloscopy, it becomes possible to avoid the formation of scars in the abdominal area. The method involves the use of local anesthesia.
Fertiloscopy is not as common in government medical institutions, therefore it is carried out less frequently than other manipulations. However, it can be assumed that this method will soon be preferred.
Perturbation
Such an examination allows not only to determine the patency of the fallopian tubes, but also to assess their tone. Pertubation involves inserting a catheter into the cavity of the reproductive organ, through which air is supplied under pressure. Carbon dioxide or oxygen is used as the substance being diagnosed. The pressure under which air is supplied does not exceed 200 mmHg. At a pressure of 90 mmHg. Normally, oviduct patency is diagnosed. This is manifested by a characteristic noise and can be recorded using x-rays. If air passes through the channels at 60 mmHg. this may indicate a decrease in the tone of the pipes. When there is no release of gas into the abdominal cavity, this becomes a symptom of tubal infertility.
With the help of perturbation, it is possible to separate small adhesions and restore the functionality of the fallopian tubes.
MRI
The capabilities of magnetic resonance imaging make it possible to painlessly determine the patency of the fallopian tubes. The procedure is carried out without specific preparation. On the eve of the study, the patient needs to empty her intestines and abstain from gas-forming foods.
MRI involves assessing the functionality of an organ using a magnet. To do this, the patient needs to be at rest for 15-20 minutes. The results of the study show whether there are adhesions in the fallopian tubes. The disadvantage of the procedure is that it does not allow assessing the functionality of the fimbriae and the tone of the oviducts. MRI of the fallopian tubes is rarely prescribed. It is usually prescribed if a tumor is suspected.
Which method is better
All methods of checking the patency of the fallopian tubes have their pros and cons. It is impossible to say for sure which one is better. Of course, minimally invasive interventions that do not require the use of anesthesia are safer than full-fledged operations. However, when carrying out the latter, it is possible to immediately restore the patency of the oviducts, if necessary. Procedures that involve the use of x-rays are more likely to cause concern among women. You should not worry, because the radiation exposure is minimal and cannot cause cell mutation.
It is necessary to choose a method for determining the patency of the tubes individually with the participation of a gynecologist.
Is it possible to evaluate pipes at home?
It is impossible to check the patency of the fallopian tubes at home. A woman can only suspect a pathology by characteristic features. Symptoms of fallopian tube obstruction are reduced to a list:
- inflammation in the uterus and appendages, which is characterized by painful sensations and secretions;
- adhesive process, which causes pain when moving, during sexual intercourse;
- violation menstrual function due to adnexitis;
- previously conducted surgical operations and abortions.
These signs are combined with unsuccessful pregnancy planning for 12 months or more, subject to regular sexual intercourse.
