Obstruction of the fallopian tubes (tubal infertility) causes, symptoms. Treatment of obstruction of the fallopian tubes with folk remedies using herbs

Every woman dreams of getting pregnant, enduring and giving birth to a healthy baby, but some couples are unsuccessfully trying to make this dream a reality. The most common cause of this problem is the obstruction of the fallopian tubes - a disease with which 25% of women aged 20 to 45 are familiar.

The uterine or fallopian tubes are one of the components of the female genitourinary system. They are the thinnest tubes that expand at the ends and resemble funnels. Inside the pipes there are numerous villi, which experts call fimbia.

In the middle of each cycle, a follicle matures in the female body, from which the egg is released and sent through the fallopian tubes to the uterus. In this environment, eggs mature, spermatozoa move through the tubes, which seek to fertilize the female cell. If the villi are damaged, the likelihood of fertilization is markedly reduced, and there is also a risk of developing an ectopic pregnancy. In the absence of fallopian tubes, IVF is the only way to have a child, and if a woman has one tube removed, there is a chance of getting pregnant.

Symptoms and causes of the disease

Many gynecological diseases are diagnosed on the basis of complaints from patients who report pain, heavy discharge or lumps on the chest, and other symptoms. But the girl may not be aware of the problem of obstruction until the moment of pregnancy planning. With partial obstruction, pregnancy can develop in the tubes, and if the tubes are completely obstructed, attempts to get pregnant end in failure. Complete obstruction may be the reason for the appointment of IVF.

There are several reasons for the development of this serious disease:

common infections of the urinary tract and reproductive system;
inflammatory processes in the pelvic organs;
sexually transmitted diseases;
endometriosis;
complications after abortion;
tumors of the fallopian tubes;
consequences of surgical operations;
bowel disease.

Often, the appearance of adhesions is noted even in young women who have not terminated their pregnancy and have not previously encountered gynecological problems, so it is very important to prevent hypothermia, to be protected in a reliable way.

Diagnostics

If a couple cannot conceive a child for a long time, although the man's spermogram is normal, and the woman ovulates regularly, the cause of infertility is most often obstruction of the tubes.

Several methods are used to diagnose tubal obstruction. The gynecologist must prescribe an ultrasound. A more detailed picture can be seen during the transvaginal examination of the tubes or USGSS. This is the least traumatic and fastest method of diagnosis, which is carried out without anesthesia. Before the procedure, the doctor injects saline into the patient's uterine cavity.

At the next stage of diagnosis, additional studies are carried out, including instrumental diagnostic methods. Today, diagnostic laparoscopy remains one of the most informative methods for determining obstruction, as well as other causes of female infertility. The use of fertiloscopy also makes it possible to make an accurate diagnosis.

The course of the disease

With proper and timely treatment of tubal obstruction, many women manage to become pregnant.

In gynecology, the following methods are used to treat obstruction:

pipe blowing,
laparoscopy,
the use of drugs that promote the resorption of fresh adhesions.

Tubal plasty is one of the most popular and quite effective surgical methods for the treatment of adhesions.

Doctors prescribe additional procedures for women with tubal obstruction. Electrophoresis with salts of magnesium, iodine and potassium, as well as ultraphonophoresis with a solution of vitamin E, Lidase, Hyaluronidase are quite popular.

Electrical stimulation of the uterus and appendages, mud applications, gynecological massage, EHF-therapy, which is carried out after laparoscopy, helps to achieve positive dynamics.

Treatment with folk remedies

Treatment of obstruction of the fallopian tubes with folk remedies is quite popular, it is painless, does not require significant financial costs and, unlike other methods of treatment, does not harm other body systems.

Cleaning the fallopian tubes with folk remedies can be an alternative to conservative methods or used as an additional type of treatment. The use of a cinquefoil is quite popular for cleaning pipes. It is necessary to pour a spoonful of grass with vodka (300 ml). The solution must be infused for at least three weeks. It is necessary to drink tincture of cinquefoil three times a day, dilute one spoonful of the product in 50 ml of water.

Another method of treatment is based on the use of psyllium seeds. A teaspoon of seeds should be poured with a glass of boiling water and boiled over low heat for several minutes. A woman should take a decoction three times a day and drink a third of a glass at a time.

The effectiveness of the treatment of obstruction with an extract from the uterine carnation, which has a positive effect on the condition of the tubes and muscles of the uterus, has been proven. You can also drink decoctions of the following herbs:

round-leaved wintergreen,
goose cinquefoil,
juniper,
field yaruki,
Hypericum.

Herbs for obstruction of the fallopian tubes work in a complex way, they are used to treat ovarian cysts and other gynecological diseases. Phytotherapists recommend using a collection of chicory root, nettle, rose hips, sea buckthorn, celandine, bird cherry, calendula, chamomile and pepper mountaineer for cicatricial processes. The mixture is poured with boiling water and infused for several hours.

Other home treatment options

Treatment of disorders of the reproductive system can be supplemented by taking burdock juice and douching with tincture of celandine, such a remedy as a beaver uterus, bergenia root and flax seeds is also popular.

Women who have been diagnosed with an obstruction can try honey and propolis tampons as a treatment. It is necessary to take into account the fact that honey is one of the most common allergens when choosing this method. Help to get pregnant balls of honey and herbs, which must be consumed within twenty days.

Recipes

Alternative treatment of obstruction of the fallopian tubes will help to feel the joy of motherhood. Herbs for infertility can solve not only such a problem as obstruction of the pipes, but also improve the health of the female body, prepare it for pregnancy. Phytocenter specialists have the necessary knowledge and experience, they can recommend herbs that you need to drink in case of obstruction of the fallopian tubes. They will offer recipes taking into account the woman's health status and the complexity of the disease, tell about the methods of preparing tinctures and the features of their use.

Consider some of the most basic methods and recipes for the treatment of obstruction of the fallopian tubes with folk remedies:

One of the leading methods is the use of psyllium seeds. Pour 1 teaspoon of plantain seeds with 1 cup of boiling water, cook over low heat for 5 minutes, stirring constantly. Take 1/3 cup of decoction 3 times a day 30 minutes before meals
An equally effective remedy for the treatment of obstruction of the fallopian tubes is an extract from the herb of the uterine carnation. The uterine carnation not only fights the obstruction of the tubes, but also straightens the villi in the tubes and strengthens the muscles of the uterus, preparing it for the gestation period, which is not unimportant.
Collection of herbs for ovarian cysts, cystomas of the ovaries and fallopian tubes, with obstruction of the fallopian tubes. Ingredients: chicory root, nettle, rose hips, peppercorn, celandine, sea buckthorn, calendula, chamomile, bird cherry. How to use: 1 tbsp. Pour a spoonful of the mixture with 1 cup of boiling water, leave for 4-6 hours, strain. Take warm 1/3 cup 3 times a day 1 hour before meals. The course of treatment is 1 month, a break of 2 weeks, then the 2nd course, etc. of necessity. In addition to the collection, it is necessary to take burdock juice according to the following scheme: 1st and 2nd days, 1 tsp. 2 times a day, 3rd and 4th days - 1 tsp. 3 times a day, then 1 tbsp. l. 3 times a day for a month.

In addition, you can douche with infusion of celandine (0.5 liters).

Nowadays, there are often women, especially young ones, who suffer from infertility. None of them did early abortions, did not endure any operations, where did infertility come from? The reason for the impossibility of getting pregnant is often the problem of obstruction of the fallopian tubes. This pathology does not harm the health of a woman.

The fallopian tubes play a very important role in the fertilization process. They help the fertilized egg to reach the uterus, where the further development of the embryo takes place.

Symptoms of obstruction of the fallopian tubes

Recognizing tubal obstruction is very difficult. After all, this pathology does not disturb the body, the woman feels normal, there are no specific symptoms.

The reason to recognize the problem in the oviducts are unsuccessful attempts to get pregnant for a long time.

Very rarely, women experience pulling pains in the lower abdomen, fever is possible. They can appear as a result of inflammation of the appendages or the occurrence of adhesions, after surgery.

Causes of obstruction of the fallopian tubes

inflammatory processes. They can be caused by germs and bacteria that enter the tubes from the vagina. Common infections are chlamydia, mycoplasmosis and ureaplasmosis.
Endometriosis.
Ectopic pregnancy.
The appearance of adhesions and scars that can block the pipes.
Tuberculosis of the female genital organs.
The appearance of tumors (myoma, fibroma), which are located next to the tubes and can block the lumen.
Polyps of the fallopian tubes.
Born malformations of the appendages.

Methods for determining obstruction

With the help of an x-ray machine (hysterosalpingography). This method is the most informative of non-traumatic studies, although it gives frequent errors.
With the help of ultrasound (hydrosonography). A solution is injected into the uterine cavity, the progress of which is observed on ultrasound. Particular attention is paid to the structure of organs located near the pipes, as well as the search for adhesions and new formations. The ultrasound process itself takes about 15 minutes, is a painless method with immediate results.
Surgically. Laparoscopy (through incisions in the abdominal cavity) and fertiloscopy (through incisions in the vagina).

But most often they study the regularity of ovulation in a woman, using a vaginal sensor, they examine the vagina, cervix and its cavity. In parallel, the analysis of the sperm of the sexual partner is carried out. If there are no problems, then most likely the woman has an obstruction of the fallopian tubes.

Treatment of obstruction of the uterine tubes

There are two types of treatment for this problem:

Operational.
Conservative (medicines, physiotherapy, folk remedies).

Surgical treatment

Surgical intervention is most often simply necessary, in cases where medications do not help, it is necessary to remove the barrier that closes the lumen of the tubes.

The main methods of surgical intervention are:

Laparoscopic. The most common method using special equipment. Through the vagina, anus or specially made incisions on the wall of the abdomen, equipment is introduced into the pelvic cavity, with the help of which the cause of the obstruction of the tubes is eliminated. If during the operation new data are found out or the removal process is complicated, the surgeon can switch to the laparotomy method.
Laparotomy. There is a longitudinal dissection of the abdominal wall, which provides a large scope for surgical operations. After this operation, a scar remains, and postoperative recovery (5-7 days) is also required. In some cases, surgery is simply necessary, for example, with progressive peritonitis.
Reconstructive. This method cannot be called reliable. After all, there are no requirements for materials and techniques. It consists in the use of synthetic materials, that is, the lumen of the pipe is expanded artificially. Although unreliable, many women turn to reconstructive surgery as their last hope of becoming pregnant.

Conservative methods are aimed at eliminating inflammatory processes. The first stage of these types of treatment is the elimination of such influences as drafts, cold, high humidity and infectious diseases of the genitourinary tract.

Medical treatment

Most often, three types of drugs are prescribed in the complex for the treatment of tubal obstruction:

Anti-inflammatory. Assign to stop the inflammatory process. Preparations can be in the form of tablets or suppositories (suppositories). Such as: Diclofenac, Phenylbutazone, Cortisone, Indomethacin. All these drugs have analgesic, anti-inflammatory and antipyretic properties.
Antibiotics. Assign to eliminate the direct cause of the inflammatory process - the bacterial flora. Not every clinic does an antibiogram, which determines the sensitivity of the bacterium. In most cases, broad-spectrum drugs are prescribed that attack microbes and bacteria of various origins. Representatives of such antibiotics are: Metronidazole, Kanamycin, Chloramphenicol and Tetracycline.
Hormones. Assign in cases of vascular disorders that are associated with the inflammatory process. Inflammation of the fallopian tubes can be associated with hormonal imbalance, which also provokes a failure of the menstrual cycle. Do not give up hormonal drugs because of scary stories on the Internet, especially if you need it.

Drug treatment should be taken only in combination, separately you will not achieve the desired result.

Physiotherapy treatment

Treatment will be more effective if medication is taken in parallel with physiotherapy procedures.

The following types of procedures can be assigned:

Balneotherapy. It is aimed at increasing immunity and reducing functional disorders. Resorts with nitrogen-siliceous and hydrogen sulfide waters are recommended.
Electrophoresis. In the process, under the influence of an electromagnetic field, magnesium and calcium salts, biogenic and enzyme preparations are introduced into the pelvic cavity. This speeds up drug treatment, and also reduces the damage done to other organs by the drugs used.
Ultrasonic massage. With the help of sound waves, tissue micromassage is performed. Thus, blood circulation of tissues improves, adhesions soften, pain decreases.
Electrical stimulation of the appendages and uterus. From the 6th day of the menstrual cycle, monopolar impulses with a certain frequency begin to be applied to muscle contraction. It turns out a kind of massage, which lasts about 5 minutes and has a beneficial effect on the general condition of the patient.
Gynecological massage. Contraindicated in acute inflammatory process. This procedure is prescribed in parallel with drug treatment. As a result, the blood circulation of the pelvic organs improves, and adhesions are stretched and eliminated.

Treatment with folk remedies

A popular treatment for tubal obstruction is the use of a boron uterus. Ortilia lopsided (upland uterus) has healing properties. With the help of this herb, many have been able to overcome the problem of infertility. It treats many gynecological diseases, boosts immunity, and also restores hormonal balance.

How to prepare a tincture for treatment? 5 st. l. dry plant (crushed flowers, stems and leaves) is poured with vodka (0.5 l). Infuse for 15 days in a dark place, be sure to shake occasionally. Take 40 drops three times a day one hour before meals.

No less effective are common cinquefoil and milk thistle.

milk thistle: 1 tsp herbs (seeds) pour 250 ml of dill, leave for 15 minutes. Drink hot, three times a day 30 minutes before meals, in the evening - before bedtime.

Common cinquefoil: 1 tbsp. l. herbs pour 300 ml of vodka. Insist three weeks.

Reception: for 50 ml of water - 1 tbsp. a spoon. Take three times a day.

Hydrotherapy treatment

For the treatment of obstruction of the tubes in traditional medicine, a method of treatment with leeches (hirudotherapy) is used.

This procedure is offered by many clinics. The entire process of the procedure should be carried out under the supervision of an experienced specialist. The duration of the session is 1 hour. The course of treatment averages 10-15 sessions.

3-4 leeches are applied to the skin in the uterus. They can also install leeches near the vagina. At the end of the session, you do not need to remove the leeches, they fall off on their own.

Upon contact, the leech will release therapeutic enzymes that can relieve inflammation and adhesions, and also normalize the hormonal background of a woman.

If you have found obstruction of the fallopian tubes, do not despair. This ailment is not insurmountable. There are many ways to treat. After the examination, you need to consult with your doctor and choose the most appropriate method of treatment. If you follow all the recommendations, you will definitely achieve the desired result.

Violation of the patency of the fallopian tubes (obstruction of the fallopian tubes) is one of the most common causes of infertility in women. The ability to conceive can be impaired due to the surgical removal of the tubes due to an ectopic pregnancy, a violation for one reason or another of the anatomical structure of the fallopian tubes, the appearance of an obstacle in the lumen of the tube (most often the result of an adhesive process), which excludes the possibility of meeting gametes (eggs and spermatozoa), or, finally, functional failure of the fallopian tubes.

The uterine (fallopian) tubes are paired anatomically associated formations with the uterus, extending from it and closely adjoining the ovaries with their ampullary end. The ampullar end of the tube is a funnel, the fimbria of which, like the inner surface of the tube, are lined with ciliated epithelium. Essentially, ovulation, i.e. the release of the egg from the ovary occurs in the abdominal cavity, after which, with the help of the movement of the cilia, the egg enters the tube, where it is fertilized.

Causes of obstruction of the fallopian tubes

The main causes of obstruction of the fallopian tubes are:

1. Inflammatory processes in the female genital organs
2. Various operations in the abdominal cavity, including operations on the internal genital organs (abortion, tube resection for ectopic pregnancy, removal of foci with signs of chronic inflammation, endometriosis and retention cysts, etc.)
3. Birth defects
4. Functional disorders

1. Inflammatory processes in the female genital organs as a cause of obstruction of the fallopian tubes

As a rule, our clients, turning to a reproductologist about tubal infertility, received this insidious disease precisely as a result of an inflammatory process in the pelvic organs. Various infectious diseases, including STDs, abortions, childbirth complicated by infection - all this can cause inflammation and the formation of adhesions on damaged tissues. They are films of connective tissue of various thicknesses that narrow the lumen of the tubal canal and, as a result, cause tubal infertility. In this case, the connective tissue does not appear inside the tube, but around it, squeezing the channel, changing the anatomical structure of the tube and creating obstruction of the fallopian tubes, which makes it impossible to advance the sex cells.

2. Abdominal operations can also cause obstruction of the fallopian tubes

During operations on the pelvic organs (for example, during medical abortions, removal of tumors in the uterus, cysts on the ovaries, resection of the tube (s) due to ectopic pregnancy, etc.), scar tissue can also form around the fallopian tubes - adhesions, which also can lead to tubal infertility. It should be emphasized that during any abdominal operation (for example, surgery for appendicitis), adhesions can form as a result of the so-called aseptic inflammation.

3. Birth defects

Partial or complete absence of tubes resulting from genetic abnormalities can also be considered as a cause of tubal infertility.

4. Functional disorders leading to tubal infertility

All causes of obstruction of the fallopian tubes associated with the formation of adhesions or birth defects are called organic. But there is another etiology of this disease, based on various functional shifts. At the same time, the activity of the fallopian tubes is also disrupted, although their structure itself does not change. Hormonal disruptions can also become a problem, leading to disruption of the movement of the fimbriae (cilia lining the inner surface of the tube) that promote the egg to the uterus. The psychological factor should not be discounted either, because due to frequent stress (including due to infertility), some women experience a spasm of the muscles of the fallopian tubes and, as a result, their compression.

Types of obstruction of the fallopian tubes

According to the severity of the disease process, obstruction of the fallopian tubes can be:

complete
partial

With complete obstruction of the fallopian tubes, the lumen of the tubal canal is completely blocked, and with partial obstruction, in some places. The last type - partial obstruction of the fallopian tubes - is quite insidious, as it can lead to an ectopic pregnancy.

Symptoms of tubal infertility and obstruction of the fallopian tubes

Obstruction of the fallopian tubes does not manifest itself as pain or malaise, that is, a woman may not
guess about this pathology. Among the main symptoms of obstruction of the fallopian tubes is the non-occurrence of pregnancy within a year during sexual activity without protection from pregnancy. Also, if the block blocked the path of an already fertilized egg, the embryo, developing directly in the tube, can be implanted in the tube, and then an ectopic (tubal) pregnancy occurs. At a certain stage in the development of the process, this makes itself felt with sharp pains in the lower abdomen, nausea, darkening of the eyes, and fainting. Such conditions require immediate hospitalization. The degree of patency and various symptoms of obstruction of the fallopian tubes (adhesions, anatomical changes in the condition of the tubes, some signs of inflammation) can only be assessed by a doctor during the hysterosalpingography procedure (an x-ray with a preliminary introduction into the uterine cavity of a special substance that visualizes the fallopian tubes) or sonohysterosalpingoscopy (ultrasound study) .

Methods of dealing with tubal infertility

If the causes of tubal infertility are functional disorders, then to eliminate them, they resort to conservative treatment, during which nervous tension is relieved and the hormonal background is restored. Partial obstruction can be cured by laparoscopy. With complete obstruction, all these measures do not work. The only effective way to experience the joy of motherhood in this case is in vitro fertilization (IVF), which can be professionally performed at the Baltic Institute of Human Reproduction. With IVF, the fallopian tubes are not involved at all, so their condition does not play any role. The egg is fertilized by a sperm cell in a test tube, and then the embryo is implanted directly into the woman's uterus.

Tubal obstruction- a serious disease of the reproductive system of the female body and a common cause of infertility. Pathology develops due to the influence of many factors. Women of childbearing age need to be aware of what its signs and symptoms are, how to check if tubal obstruction can be cured, and whether pregnancy is possible with this diagnosis.

The fallopian tubes are a paired organ of the female reproductive system, which looks like two thin elongated cylinders. They provide communication between two cavities - the abdominal and uterus, and also contribute to the capture and further movement of the egg released from the ovary directly into the abdominal cavity, and the promotion of spermatozoa from the uterus to the egg through chemotaxis. The properties of the tubes ensure the normal physiological process of fertilization.

The term "obstruction of the fallopian tubes" characterizes the condition in which there is a violation of the transport function of the fallopian tubes. In this case, the obturation of the internal space of these organs occurs and the patency is partially or completely disturbed.

What signs indicate obstruction of the fallopian tubes

Pathology may not manifest itself in any way for many years and even decades. Often there is a latent course of this disease. If there is a history of infectious or non-infectious inflammatory processes of the organs of the reproductive system in a woman, then the following symptoms of obstruction of the fallopian tubes are noted:

pain in the lower abdomen;
pathological changes in vaginal discharge (change in color, odor);
painful menstruation;
intensive and significant weight loss (with tumor processes).

All these signs are indirect, and additional studies are required to make a reliable diagnosis and determine the cause.

The complaint of patients about the inability to become pregnant is the most characteristic and common in this pathology and is a guideline for the appearance of suspicions in the gynecologist of tubal obstruction.

Why does pathology develop?

Obstruction of the fallopian tubes is a polyetiological disease, i.e. There are many reasons and predisposing factors contributing to its occurrence.

Statistics of practical gynecology reports that the most common factor in violation of patency is the formation of adhesions in the pelvic cavity and / or in the lumen of the fallopian tubes themselves.

Spikes develop for many reasons:

after suffering infectious and / or inflammatory diseases of the female reproductive system (salpingitis, oophoritis, etc.);
after surgical interventions in the pelvic cavity, on the internal genital organs;
chronic inflammatory diseases of the uterus, fallopian tubes;
congenital malformations of the formation and abnormal structure of the organs of the reproductive system and small pelvis.

Also, bulky tumors of the fallopian tubes, ovaries, uterus, or other nearby organs can contribute to compression and obstruction of the tubes.

Types of disease

There are many types of tubal obstruction. This pathology is classified according to:

Sides of defeat:

unilateral (left or right);
bilateral.

The level of occlusion of the lumen in:

intramural area;
isthmus;
sinuous part;
funnel area.

Degrees of lumen closure:

partial obstruction of the fallopian tubes;
complete obstruction of the fallopian tubes.

Causes of obstruction of the fallopian tubes:

anatomical obstruction (due to mechanical occlusion of the lumen: with swelling of the mucous layer, compression by the tumor, due to the growth and increase in the volume of the polyp, etc.);
functional obstruction (no structural changes are observed on the part of the pipes).

What threatens and what affects the obstruction of the fallopian tubes

The prognosis of this disease directly depends on its cause. With inflammatory processes, the condition will gradually worsen, the painful syndrome and other manifestations will increase.

With a tumor process, everything is much more serious. Uncontrolled tumor growth, the degeneration of a neoplasm from benign to malignant often leads to death.

In the absence of treatment of tubal obstruction, fertilization and further pregnancy will most likely become impossible.

Diagnosis of obstruction of the fallopian tubes

Diagnostic activities include:

x-ray examination of the pelvic organs with contrast;
Ultrasound (the most common examination, which shows the condition of the fallopian tubes and their obstruction);
Endoscopic examination (the most informative and indicative). It could be:
Hysteroscopy - the introduction of a special device with a camera into the uterine cavity with its further advancement to the oviducts.
Laparoscopy for obstruction of the fallopian tubes - the introduction of an endoscope (camera) into the pelvic cavity.

All these methods give a visual representation of the state of the reproductive organs of a woman, in particular the fallopian tubes. They allow not only to determine the presence of obstruction, but also to identify the cause of the development of pathology.

After receiving the necessary data, the specialist conducts an analysis for the patency of the fallopian tubes. With a confirmed diagnosis, an individual treatment is selected.

How to treat obstruction of the fallopian tubes?

Treatment of obstruction of the fallopian tubes includes conservative and surgical methods.

Conservative methods of treating obstruction of the fallopian tubes include pharmacotherapy of infectious and inflammatory diseases that led to obstruction (elimination of pathogenic pathogens and leveling of inflammatory symptoms).

The purpose of the operation for obstruction of the fallopian tubes is to ensure complete patency of the lumen of the tubes by removing cysts, polyps, tumors, adhesions, etc.

Surgical interventions are performed under general anesthesia.

Fallopian tube obstruction: impact on conception

Complete obturation (overlapping) of the cavity of the fallopian tubes means the impossibility of penetration of the egg into the uterine cavity and conception. With this type of disease, pregnancy is impossible without proper treatment.

With partial obstruction of the fallopian tubes, you can get pregnant. However, with this type of pathology, the risk of developing an ectopic (tubal) pregnancy significantly increases. This condition in many cases is life-threatening for the mother and fetus.

How to get pregnant if obstruction of the fallopian tubes is diagnosed? To do this, you should seek qualified medical assistance at the Genesis reproduction center. After the diagnosis, the doctor will individually select therapeutic measures and give recommendations on pregnancy planning.

One of the most modern methods of dealing with problematic pregnancy in our country is IVF for obstruction of the fallopian tubes.

Violation of the patency of the fallopian tubes is the most common cause of female infertility.

The fallopian tubes leave the uterus and lead to the ovary. At the end of each tube are villi - fimbriae - which direct the egg from the ovary to the tube. Normally, the tubes carry out the function of transporting sperm to the egg, and then the fertilized egg to the uterus. The movement of the egg is due to contractions of the tubes. If their function is impaired, spermatozoa may not reach the egg. Another situation is also possible (with partial obstruction): the spermatozoon fertilizes the egg, but the transport of this fertilized egg to the uterus is disrupted. This is dangerous with the onset of an ectopic pregnancy.

The obstruction of the fallopian tubes can be organic (that is, there are some anatomical changes in the tubes, mechanical obstacles that disrupt their patency), or functional (the structure of the tubes is not changed, no mechanical factors prevent their patency, however, the function of the tubes is impaired and, consequently, the transport of spermatozoa to the ovum, and of the fertilized ovum to the uterus, is difficult).

The most common cause of tubal obstruction is inflammation. It can be caused by sexually transmitted diseases, infectious complications after an abortion. As a result of the inflammatory process in the cavity of the small pelvis, where the genitals are located, adhesions (films of connective tissue) are formed, which can completely or partially close the lumen of the tube, lead to compression of the tube from the outside, pathological bends of the tubes, disruption of the structure of the fimbriae. Adhesions between the tube and the ovary can prevent an egg from entering the tube. They can also mix the ovaries and fallopian tubes, disrupting their normal anatomy.

The most common cause of organic obstruction of the fallopian tubes is chlamydia. . Unfortunately, in most cases this disease is asymptomatic, a woman may not even know that she has an infection. According to some reports, chlamydia is found in half of women with obstruction of the fallopian tubes.

The adhesive process can develop after operations on the pelvic organs (removal of fibroids, removal of the tube after an ectopic pregnancy, removal of ovarian cysts, caesarean section). In some cases, obstruction of the tubes may develop after operations on the abdominal organs, for example, after appendicitis. Especially often, adhesions leading to tubal obstruction are formed if the operation and the postoperative period proceeded with complications. After laparoscopic surgery, adhesions are formed much less frequently than after abdominal surgery.

The cause of functional obstruction of the pipes and disruption of their work can be both inflammatory processes and hormonal disorders, psycho-emotional instability, chronic stress.

Diagnosis of obstruction of the fallopian tubes

Obstruction of the fallopian tubes may not manifest itself for a long time. It is usually discovered after a woman seeks medical help and begins to be examined in connection with infertility.

The main methods for checking the patency of the fallopian tubes are hysterosalpingography (HSG), echohysterosalpingoscopy and laparoscopy.

Hysterosalpingography It consists in the fact that a contrast agent is injected into the fallopian tubes through the cervical canal, and an x-ray is taken, which shows whether the contrast has penetrated into the tubes and how far it has reached. This procedure is carried out in the first phase of the cycle to avoid irradiation of the egg. Some doctors believe that the procedure may also have a therapeutic effect due to the washing effect of the injected solution.

In 20% of cases, HSG can show a false negative result: the contrast agent does not enter the tubes, not because of their obstruction, but because of spasm of the tube.

Another method for checking the diagnosis of the fallopian tubes is echohysterosalpingoscopy . A saline solution is injected through the cervical canal, then an ultrasound is performed. With obstruction of the fallopian tubes, the uterus stretches, its cavity expands. The information content of the method is lower than the HSG, but there is no radiation effect, so the study can be repeated several times.

At laparoscopy three punctures are made on the abdomen: in the navel and on the sides. At the same time, a video camera is inserted into one puncture (an enlarged image is displayed on the monitor screen), and instruments are inserted into the other 2. With laparoscopy, it is possible to diagnose not only impaired patency of the fallopian tubes, but also other causes of infertility (polycystic ovaries, endometriosis, etc.). Usually, therapeutic and diagnostic laparoscopy is performed, that is, not only the pelvic organs are examined and the patency of the fallopian tubes is checked, but also the elimination of existing disorders (as far as possible). To assess the patency of the tubes through the cervical canal, a solution is introduced, which should normally enter the tubes and pour into the abdominal cavity.

Treatment

Conservative treatment consists of anti-inflammatory treatment, physiotherapy. In the presence of adhesions, conservative treatment is not effective. The effect is possible only if treatment is started within 6 months after the inflammatory process.

Previously used pertubations (blowing of the fallopian tubes) and hydrotubation (introduction of liquid under pressure into the fallopian tubes) are practically not used at present due to low efficiency and the risk of complications (overstretching of the fallopian tubes, exacerbation of a chronic inflammatory process).

The main method of treatment of obstruction of the fallopian tubes is currently operational. The operation is performed by laparoscopy. At the same time, the adhesions in the pelvic cavity are dissected, the patency of the tube is restored if possible, the fimbriae are released from adhesions. The effect of the operation depends on the degree of violations and on which section of the pipe the patency is impaired. If the adhesions are only around the pipes, then the operations are effective in 60% of cases, with the development of the adhesion process inside the pipe, the efficiency is not more than 10%. With complete obstruction of the pipes throughout the operation, they are ineffective, since even with the restoration of the mechanical patency of the pipes, it is not possible to restore their normal function. If the structure of the tubes is greatly changed by the inflammatory process, a large amount of fluid is found inside, they are stretched, then such tubes are removed, since not only is it impossible to restore their function, but they can even prevent pregnancy during IVF (due to the inflammatory process, tubes form toxic metabolic products that adversely affect the egg).

In some cases, the effectiveness of the operation is reduced due to the re-formation of adhesions after the operation, so the maximum effect is usually observed in the first six months after the operation.

With the ineffectiveness of the first laparoscopy, repeated operations in most cases are also ineffective.

If pregnancy does not occur after surgery, in vitro fertilization (IVF) is the method of choice.

Treatment of functional tubal infertility consists in the correction of hormonal levels, psychotherapy, and the use of sedatives.

Prevention

Termination of pregnancy and gynecological operations should be done only in the absence of any inflammatory process of the genital organs. It is possible to carry out preventive local treatment before medical intervention (suppositories hexicon or betadine for 5 days).

In the absence of a permanent sexual partner, condoms are the method of choice for contraception, as they protect not only from unwanted pregnancy, but also from infections.

The number of abortions should be kept to a minimum, as a last resort it is better to use emergency contraception in time.