Fallopian tube obstruction

Obstruction of the fallopian tubes is a serious disease that develops due to the presence of foreign cells inside the fallopian tubes. This leads to the fact that sperm and eggs cannot move freely through them. Among gynecologists, there is an opinion that obstruction of the fallopian tubes is one of the main causes of infertility in women.

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Epidemiology

According to statistics, 25% of all women in the world who are infertile suffer from obstruction of the fallopian tubes. It is worth paying attention to the fact that a foreign cell can interfere not in the tube itself, but even between the ovaries and the tube, creating a kind of adhesion. In this case, doctors diagnose difficult infertility.

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Causes fallopian tube obstruction

Today, doctors know the following causes of obstruction of the fallopian tubes:

1. Conducting various surgical interventions. This happens especially often if the operation lasts long enough, if there is a purulent process, bleeding.
2. Transfer of some diseases to the female part. For example, during salpingitis, the external opening of the tube can "close", and harmful microorganisms develop in the peritoneum.
3. Some sexually transmitted diseases (gonorrhea, chlamydia).
4. The development of endometriosis, when tissue similar to the structure of the uterus grows.
5. The appearance of adhesions due to abortion, inflammation of the appendages, cauterization of the cervix, cesarean section, uterine trauma.

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Pathogenesis

Obstruction of the fallopian tubes sometimes occurs even in women who have never been diagnosed with any gynecological diseases.

Often, pathogenesis develops in those who have undergone any surgical interventions (including cauterization), as well as due to heredity (it happens that the fallopian tubes are absent or underdeveloped).

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Symptoms fallopian tube obstruction

The biggest problem with this disease is the fact that it is completely asymptomatic. That is, a woman may not even suspect that she is sick. Sometimes it is possible to suspect something is wrong if there is causeless pain in the lower abdomen, bleeding and high temperature. All this indicates an inflammatory process, in which case it is necessary to immediately contact a gynecologist. Another symptom can be called the inability to get pregnant, especially if the couple has been planning this for a long time.

First signs

As mentioned above, this pathology develops without any particularly noticeable symptoms, so women do not rush to see a gynecologist. But the first signs of obstruction of the fallopian tubes are still there and they need to be given special attention. You should immediately visit a doctor if you have:

1. Frequent yellow discharge.
2. My period is very painful.
3. Sexual intercourse is accompanied by unpleasant sensations in the lower abdomen.
4. Sometimes you feel a nagging pain.

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Forms

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Complete obstruction of the fallopian tubes

There are two types of tubal obstruction: complete and partial. Complete tubal obstruction is a serious condition in which a woman cannot become pregnant naturally. In this case, mandatory treatment is offered, as well as the possibility of artificial fertilization (intrauterine insemination or in vitro fertilization).

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Partial obstruction of the fallopian tubes

Partial obstruction of the fallopian tubes means that sperm can easily reach the egg and fertilize it, but the egg does not reach the uterus, which can cause an ectopic pregnancy.

Obstruction of both fallopian tubes

Most often, patients have obstruction of only one fallopian tube. In this case, after proper medical intervention (surgically), we can talk about the possibility of getting pregnant. Sometimes artificial pregnancy is also suggested. But sometimes obstruction of both fallopian tubes occurs, which develops due to hereditary reasons or as a result of some anomalies.

Complications and consequences

The most important problem that many women with blocked fallopian tubes experience is infertility. That is why doctors recommend undergoing a gynecological examination at least twice a year. This will allow diagnosing and treating the pathology at its very inception.

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Is it possible to get pregnant with blocked fallopian tubes?

Of course, such a diagnosis is disappointing, but if the patient has only one obstructed fallopian tube, then pregnancy is quite possible. Only a qualified doctor can say for sure what percentage of conceiving a child. In addition, the functional state of the ovaries plays an important role here, as well as the cause of the obstruction. At the same time, this disease does not pose any threat to the woman's life.

According to statistics, after undergoing IVF, a woman has a 60% chance of getting pregnant and giving birth to a healthy child. The effectiveness of this procedure will be noticeable two weeks after it is performed. Surgical operations are considered the most successful. After them, the chance of fertilization increases to 70%. Only in cases of advanced obstruction does surgical intervention bring a 20% chance. The results can be seen only a year after the operation (if the woman has a regular sex life).

As you can see, it is possible to get pregnant with such a disease if you undergo comprehensive treatment in time.

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Complications

Even if you have been diagnosed with blocked fallopian tubes and have undergone correct treatment, complications may sometimes arise during pregnancy. The most common complication is an ectopic pregnancy. After IVF, it occurs in 2% of cases, after surgery - in 30%.

Complications after obstruction can cause inflammation in the ovaries, uterine cavity. Pus can also accumulate in the fallopian tube, which always requires urgent hospitalization.

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Diagnostics fallopian tube obstruction

It is worth understanding right away that if doctors notice the pathology in time and begin treatment, then its results for the patient will be more effective. That is why it is necessary to visit a gynecologist at least once every six months. If there is a suspicion of obstruction of the fallopian tubes, the doctor first determines the regularity of ovulation using ultrasound. As a rule, a regular form is carried out, but in some cases, transvaginal ultrasound may be needed. At the same time, the patient's partner must give sperm for analysis. If both partners have normal tests, but pregnancy does not occur, then most likely the whole thing is in the obstruction.

How is the diagnosis carried out?

1. UZGSS (Hydrosonography) is considered a modern alternative to transvaginal ultrasound. This study does not have highly accurate results, but is non-traumatic and completely safe. Before conducting UZGSS, a special liquid is injected into the uterus, which smooths out its walls. After that, the liquid begins to flow out. If the tubes are normal, it will first pass through them and then reach the abdominal cavity. If the fallopian tubes are obstructed, the liquid will not be able to pass through them and will stretch the uterus. With partial obstruction, the outflow process will be slow. Of course, it is impossible to see a complete picture using hydrosonography, but it is possible to diagnose pathology.
2. HSG (Hysterosalpingography or X-ray) – despite its high efficiency, it is rarely used in modern medicine. The fact is that in the process it is necessary to inject a radioactive substance into the uterus, after which it is possible to take pictures. Usually, this method is used when tuberculosis of the uterus is suspected, but it is also possible when the tubes are blocked.
3. Laparoscopy – is performed using a special solution that must be injected into the patient’s uterus. The liquid, as in the case of hydrosonography, passes through the tubes if they are passable. The entire process is filmed on video.
4. Transvaginal hydrolaparoscopy – a small incision is made in the vagina, through which it is possible to view the condition of not only the fallopian tubes, but also the area around them.

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Tests

Before the main examination, the doctor asks patients to take some tests, since diagnostic methods can only be carried out if there are no inflammations or diseases. For example, you can be tested for herpes, syphilis, HIV, hepatitis types C and B. Sometimes a general smear is taken, which determines the flora of the vagina. Such tests are usually taken only if the obstruction of the fallopian tubes will be diagnosed using X-rays (HSG).

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Instrumental diagnostics

One of the most popular methods of instrumental diagnostics today is fertiloscopy, which is quite similar to laparoscopy. During the diagnostics, special instruments are inserted through the vagina, which allows you to better see the overall picture of the patient's condition. It is worth considering that instrumental diagnostics is a fairly traumatic method, so some doctors prefer HSG.

Ultrasound

If we talk about the diagnostic method using ultrasound (hydrosonography), then it is immediately worth paying attention to its advantages:

1. The procedure is less unpleasant than others (HSG, laparoscopy).
2. No radioactive substances are used, so the procedure is less dangerous for reproductive health.
3. After the HSG, a woman needs to use contraception for some time; after the ultrasound, this is not necessary.

But hydrosonography also has its drawbacks – the results will not be as accurate and effective, and sometimes spasms interfere with making an accurate diagnosis.

An ultrasound scan should be performed before ovulation. The fact is that it is at this time that the cervix will be most open. The day of the cycle does not matter for hydrosonography. Before undergoing it, it is recommended to take a number of tests that help determine the presence of inflammation.

Laparoscopy

This is a surgical diagnostic method. First, the doctor makes small punctures in the abdominal wall so that special optical devices can be inserted. This method is quite effective and is used to detect a variety of pathologies. After laparoscopy, patients may feel pain. If this happens, you should immediately contact a doctor. Laparoscopy is not only a diagnostic but also a therapeutic method. Today, this method is performed with the least damage to the skin. Usually, the doctor makes two small incisions. Sometimes gas can be used to improve the picture and increase the passage. A special instrument (laparoscope) is inserted into one of the incisions, which looks like a thin tube with a lens at the end. In the other, a manipulator is inserted, which helps to move the internal organs.

After laparoscopy it is necessary:

1. Spend 24 hours in the hospital so that the doctor can monitor her condition. Usually, an ultrasound is also performed at this time. You can return to work on the second or third day after the operation.
2. Avoid alcoholic drinks and hard foods for at least a few weeks. To avoid infection, postpone sexual intercourse for two to three weeks.
3. Increase physical activity gradually.

After laparoscopy, the first period will be heavy. It may last longer than usual. This is normal, because the organs inside can take a long time to heal. After the procedure, pregnancy can occur in just a few months. In this case, it is worth regularly seeing a gynecologist. If fertilization does not occur, the procedure is repeated.

Differential diagnosis

The only method of differential diagnostics for obstruction of the fallopian tubes is ultrasound gynecological examination. It helps to see how advanced the disease is, and does not injure the internal organs and skin. Unfortunately, it cannot be used to see the full picture of obstruction.

Treatment fallopian tube obstruction

First of all, it is worth understanding that none of the above diagnostic methods can give 100% certainty of the disease. Therefore, almost every patient has a chance to get pregnant. Various modern methods are used to treat obstruction, including:

1. ECO.
2. Absorption therapy.
3. Laparoscopy.

If the gynecologist has nevertheless determined that your fallopian tubes are blocked, do not despair. First, the doctor must check for other gynecological or other problems that may cause infertility. Then various examinations are carried out, which include:

1. Checking the regularity of female ovulation.
2. Determination of hormonal imbalances.
3. Checking the uterine lining for problems.
4. Spermogram for a man.

If all these tests show that the female body is functioning without failures, and the quality of male sperm is high, then the doctor can recommend two methods of treating the obstruction: surgical and conservative.

Conservative treatment includes taking various medications that are aimed at treating inflammatory processes that can occur in the uterine appendages. Here, antibiotic injections, courses of Longidaza injections, and physiotherapy (electrophoresis, which helps improve local blood circulation) are usually prescribed. But it is worth understanding that such treatment can only be effective if adhesions have just begun to develop.

Surgery is recommended only if a woman has only one blocked fallopian tube. In addition, the operation is not performed after 35 years of age or with ovulation cycle disorders.

Unfortunately, even surgical treatment does not always give a 100% result on the possibility of getting pregnant. The patency of the tubes cannot be restored if their contraction is impaired or the activity of the fimbriae does not work properly.

If the diagnosis is "obstruction of both fallopian tubes", there is no point in wasting time on treatment. In order to give birth in this case, only IVF will help. Sometimes laparoscopy is also performed, which is not only a diagnostic method.

It is worth understanding that surgical intervention in itself does not guarantee pregnancy. For a positive result, it is necessary to approach the problem comprehensively and simultaneously use resorption treatment and physiotherapy. It is also necessary to put the hormonal balance and menstrual cycle in order.

The treatment is greatly influenced by the patient's age and additional factors.

IVF with blocked fallopian tubes

IVF or In Vitro Fertilization is a modern method of treating various forms of infertility. Including complete obstruction of the fallopian tubes. Its effectiveness is not very high, since pregnancy occurs in 25-30% of cases. Before IVF, a man and a woman must take some tests. The patient takes: a blood test, does an ultrasound, is tested for hepatitis, AIDS, syphilis. Her partner must take: a spermogram. Sometimes it is necessary to conduct genetic tests. On average, taking tests and preparing for IVF will take about 14 days.

Next, the patient is prescribed hormonal drugs that will help in the maturation of several follicles. After passing all the tests, the woman undergoes a follicle puncture. The mature follicles are extracted through the vagina using a special needle. This allows you to get several eggs at once, ready for fertilization. Then, the required amount of sperm is obtained from the partner.

The conception itself is carried out in a special embryology laboratory. Using special solutions, doctors combine the egg with the sperm. In a maximum of 4 days, the embryos are ready for the next stage. The embryo is examined before being transferred to the uterus. The simplest procedure is the actual transfer. It is carried out through a special catheter. As a rule, several fertilized cells are used. After the procedure, the patient can calmly continue her normal life. But high physical and strong emotional stress should be avoided.

Medicines

The most common medications for blocked fallopian tubes are various antibiotic injections and resorption therapy. Hormonal drugs are also used to help restore balance and the menstrual cycle.

1. Placenta injections are considered especially popular today, as they help relieve possible inflammation and dissolve adhesions. The liquid has no color or sediment. It is usually recommended to inject 1 ml under the skin every day.
2. Femoston is a medical drug that helps with hormonal therapy. It contains dydrogesterone and estradiol. When it enters the female body, it helps increase the amount of estrogens. Usually one tablet is prescribed every day. Please note that you must drink it strictly at the same time.
3. Duphaston – helps restore hormonal balance. Prescribed for each patient individually in accordance with the diagnosis. Has side effects in the form of bleeding, but they occur extremely rarely. The drug should not be taken by patients with Dubin-Johnson and Rotor syndromes, it is not contraindicated during pregnancy.

Please note that medications can only be prescribed by a professional doctor. Do not self-medicate.

Suppositories for obstructed fallopian tubes

In some cases, when the fallopian tubes are blocked, special suppositories are prescribed that help dissolve adhesions:

1. Distreptaza is a suppository containing two active components (streptodornase and streptokinase). They help dissolve adhesions, blood clots and pus, but do not affect healthy cells. As a rule, one suppository is prescribed three times a day. Side effects include allergies, hyperthermia, and the possibility of bleeding.
2. Longidaza is a special complex that has anti-inflammatory, healing, antioxidant, immunomodulatory properties. Suppositories are administered in a lying position, once a day. The course is determined by the attending physician individually. Sometimes patients experience allergic reactions after using Longidaza.

Mesogel

Some doctors prescribe a completely new drug "Mesogel" to their patients. It has anti-adhesive properties. This gel copes well with the destruction of adhesions of various types. The drug is based on the natural polymer carboxymethylcellulose.

In appearance, Mesogel is distinguished by its increased viscosity, is completely colorless with a homogeneous structure. The main advantage of the drug is the fact that it does not cause allergic reactions, is non-toxic and quite effectively fights adhesions.

It is applied directly to the places where adhesions are formed. Mesogel is delivered into the abdominal cavity using a special syringe.

Folk remedies

In folk medicine, various herbs and medicinal plants are used to treat obstruction of the fallopian tubes, which help to dissolve adhesions. They are administered by douching, using tampons or by taking tinctures internally. Of course, doctors are quite skeptical about folk remedies, but some women decide to use all existing and known methods to combat blocked tubes and infertility.

In addition, it is worth understanding that tinctures and medicinal herbs have the same side effects as any medication, so if you decide to take them, you should first consult with your doctor. Please note that any problem can be eliminated faster if you carry out complex treatment.

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Leeches for obstruction of the fallopian tubes

Hirudotherapy or leech therapy is becoming increasingly popular among patients diagnosed with obstruction of the fallopian tubes. Leech saliva contains special biologically active components that improve blood circulation. This helps to quickly dissolve adhesions. In addition, hirudotherapy helps to improve the epithelium of the uterus.

To get an effective result, it is necessary to put three or four leeches on the area of the lower abdomen and the projection of the uterus. Sometimes leeches are even put inside the vagina. Wait until they fall off on their own. Continue the course for 10-15 days. Then take a 14-day break.

Massage for blocked fallopian tubes

Gynecological massage is a modern alternative to surgical treatment of obstruction of the fallopian tubes. After a full course of massage, 70% of women who had blockage become pregnant and bear children.

It is interesting that this type of massage was first developed 140 years ago by Ture Brandt. The course consists of ten procedures that are performed every day (or every other day, depending on individual characteristics). The massage must be performed by a gynecologist. It does not cause any painful sensations. The procedure is performed on a special table or gynecological chair. Please note that after the first massage, the patient may feel pain in the lower abdomen. Gynecological massage consists of 4 classic components: stroking, smoothing, vibration and rubbing.

In case of a strong process of adhesion formation, the duration of the massage can be up to 20 minutes, but in normal cases it is carried out for 3-10 minutes. Remember that the massage cannot be carried out on women with any tumors in the pelvic area, during pregnancy and in case of infectious diseases.

Mumiyo for obstruction of the fallopian tubes

Mumiyo is considered an excellent immunostimulant, it also has bactericidal and anti-inflammatory properties. Due to its composition and characteristics, mumiyo is often used in the treatment of obstruction of the fallopian tubes. How to take?

1. Mumiyo is usually taken in the form of compresses. Special tampons are soaked in a 4% solution of the drug and inserted into the vagina for the whole night. The course lasts up to 10 days. Then take a ten-day break and return to treatment again.

Remember that you cannot take alcohol or other medications during the course.

Garlic for blocked fallopian tubes

Sometimes in folk medicine, garlic is used to get the body to react to cauterization. Special products are made from the plates of this plant and a warming cauterization is performed. Doctors are skeptical about this method and do not recommend conducting experiments that can result in serious illnesses.

Chinese tampons

To get rid of adhesions, special Chinese phytotampons are often used, which in some cases show positive results. Patients noted that after 4 courses, adhesions completely dissolve. In addition, Chinese tampons help eliminate the cause of adhesions.

The advantage of Chinese herbal tampons:

1. Elimination of the inflammatory process.
2. Fast healing of wounds.
3. Normalization of vaginal microflora.

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Herbal treatment

Herbs play an important role in the treatment of obstruction of the fallopian tubes. The most popular recipes for decoctions:

1. Take 250 ml of vodka and add 20 grams of crushed dried periwinkle. Put on medium heat and bring to a boil. Reduce heat and hold for another five minutes. Cool and take 15 drops three times a day on an empty stomach.
2. When the rye ripens, it is necessary to cut a few young ears and dry them in the sun. From them it is necessary to make a weak decoction, which is taken instead of ordinary water.
3. Take one tablespoon of St. John's wort and pour a glass of boiling water. Bring to a boil, reduce heat and cook for 15 minutes. Use 100 grams three times a day on an empty stomach.

Orthilia secunda

The borovaya uterus is a medicinal herb that has long been known for its healing properties. Our ancestors used it to combat many female diseases, and it is still effective today. To treat obstruction of the fallopian tubes, the borovaya uterus is used in the following recipes:

1. Take one glass of crushed grass and add half a liter of vodka. The infusion should stand in a dark place for 15 days. Shake it from time to time. Drink 40 drops on an empty stomach. The infusion is diluted in a small amount of water so that you can drink it without problems.
2. Take an enamel bowl and pour 2 tablespoons of crushed uterus into it. Add two glasses of boiling water and cover well. You can wrap it in a cloth. Infuse for 20 minutes, after which you can drink four times a day, half a glass at a time.

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Homeopathy

The most common homeopathic remedies for the treatment of blocked fallopian tubes are:

1. Hamamelis – has the form of an ointment. The main feature is the fact that this drug helps to dissolve adhesions. Sometimes allergic reactions may occur. The course is prescribed individually.
2. "Ovarium Compositum" - regulates hormonal levels, regenerates tissues, drains the walls of the fallopian tubes. Has a slight anti-inflammatory effect. Take 1-3 times a week, one ampoule. Used as injections. Side effects include excessive salivation. There are no contraindications. The course is prescribed individually, but not more than 6 weeks.
3. "Gormel" - helps to normalize the function of female genital organs. Has an analgesic property. Available in capsules that are taken orally. There are no side effects or contraindications. The course is selected individually.
4. "Galium-Hel" - usually prescribed three times a day, 10 drops. No contraindications or side effects have been found.

Physiotherapy for tubal obstruction

Some types of physical therapy are used here:

1. Electrophoresis using various salts (Mg, I, Ca), biogenic stimulants and enzymes. Conducted every day.
2. Ultraphonophoresis - the following preparations are used: terrilitin, lidase, hyaluronidase, troxevasin ointment, calcium iodide, vitamin E solution, ichthyol. It is carried out every day.
3. Mud applications through the vagina – used every other day.
4. UHF therapy – 1 month after the surgical intervention. The course consists of thirty procedures.

Surgical treatment

If conservative treatment does not bring positive results, patients are prescribed:

1. Laparoscopy is the most popular type of surgery for blocked fallopian tubes. Special equipment is used, which can be inserted through the vagina, through the anus, or through incisions in the abdominal walls. Depending on the scope of the operation, the number of incisions may vary.
2. Laparotomy – an incision is made in the anterior abdominal wall, which allows for a large enough space for manipulation. Please note that this method of treatment leaves a scar. Recovery after surgery takes quite a long time.
3. Reconstructive surgery – special synthetic materials are used. Thanks to this method, the lumens of the tubes are artificially widened.

Laser treatment of fallopian tube obstruction

To treat fallopian tube obstruction with a laser, a light guide is inserted into the tube. Then it is connected to the occlusion and affected. To obtain positive results, the uterus is first exposed to laser radiation for 1-3 minutes. This method helps reduce inflammation and improve reparative processes.

Prevention

In order to have the opportunity to become pregnant in the future and not treat the obstruction of the fallopian tubes, any gynecological manipulations and terminations of pregnancy should be carried out with the help of an experienced doctor. It is very important to ensure that there is no inflammation during the process. Before the intervention, special treatment is often prescribed to improve the general condition of the body.

If you do not have a regular sexual partner, use only condoms for protection. Abortions cause adhesions, so think a hundred times before you decide to do this.

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Forecast

In 40% of cases, fallopian tube obstruction goes away after surgery. But here it is worth considering how serious the patient's disease is. If irreversible changes in the epithelium have occurred, the prognosis will be disappointing.

When pregnancy occurs, it should be monitored by a doctor. To avoid negative consequences, pregnant women are prescribed hormonal drugs. Planning should begin immediately before the recovery itself, since adhesions may reappear in the future.

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