theinfoway beauty Secrets and expert tips on skincare
The fallopian tubes are two hollow tubes, also called the oviducts or fallopian tubes . Like the uterus, the fallopian tubes consist of three layers: the mucous membrane, the muscular wall, and the serous membrane. Each fallopian tube is 10-12 cm long and is divided into three sections. The first section (interstitial) is located in the thickness of the uterus. The diameter of the lumen in this part of the tube is 1 mm. The second section, the isthmic (isthmic), is the middle part of the tube. The diameter of its lumen varies from 1 to 3 mm. The final, expanded section of the tube is called the ampullar. It ends with a wide opening that opens into the abdominal cavity. The diameter of the last part of the tube is 5-8 mm. The opening of the ampullar section is surrounded by fringed outgrowths – the so-called fimbriae . The largest fimbria faces the ovary and is called the ovarian fimbria. The inner mucous membrane of the fallopian tube is covered with epithelium, which has cilia.
The main function of the fallopian tubes is to ensure fertilization of the egg and transport of the zygote (embryo), which goes through the cleavage stage and the blastocyst. With the help of fimbriae, the tube “captures” the egg after it leaves the ovary. By this time, the sperm should already be in the lumen of the ampullar section. This is where they meet the egg. Thanks to the movements of the cilia of the mucous epithelium and wave-like (peristaltic) contractions of the fallopian tube muscles, the fertilized egg is transported into the uterine cavity.
Obstruction of the fallopian tubes
The fallopian tubes connect the ovary to the uterine cavity. This is where the most important event for women occurs: the egg meets the sperm, creating a new life.
Description
The fallopian tubes connect the ovary to the uterine cavity. This is where the most important event for women occurs: the egg meets the sperm, creating a new life.
Obstruction (blockage) of the fallopian tubes is a big problem for the body. The blockage prevents spermatozoa moving into the tube through the uterus from reaching the egg to fertilize it. And if conception does occur, the embryo, which is large, does not enter the uterine cavity. In this case, a tubal (ectopic) pregnancy occurs, which is dangerous for the woman’s life.
According to statistics, 25-30% of women with infertility and 6% with ectopic pregnancy have obstruction of the fallopian tubes.
Why does tubal obstruction occur?
The causes of obstruction may be mechanical and functional, congenital and acquired. Congenital obstruction is associated with abnormal intrauterine development of the genitals.
Mechanical causes:
- Most often, the source of obstruction is sexually transmitted infections that cause inflammation of the internal organs. Gonorrhea or chlamydia are especially dangerous. The pathogens provoke purulent inflammation inside the tubes, as a result of which they “stick together”. Connective tissue grows outside or inside the tube, narrowing the lumen of the organ. Since the diameter of the opening inside the tube is only 2-4 mm, adhesions form quickly.
- Obstruction of the tubes also occurs with endometriosis, when the endometrium, the tissue located in the uterine cavity, grows in the tube or ovary. An adhesion process occurs inside the fallopian tube.
- Often the tubes become blocked after abortions, gynecological and surgical operations due to postoperative tissue inflammation, hardening of sutures and scars, and tumors.
Functional obstruction
In case of functional obstruction, there are no permanent obstacles inside the tube and the lumen may not be reduced, but the egg still does not move. The main reason is hormonal imbalances, which lead to a slowdown in the movement of the cilia (fimbriae) lining the tubes from the inside. Spasms of the tubes, which have occurred at some time due to improper functioning of the nervous system, can also be the cause of functional obstruction.
What does a woman feel when she has blocked tubes?
Tubal obstruction often causes no symptoms, and a woman is unaware of it until she faces the problem of infertility. Sometimes the disease is detected after an ectopic pregnancy, caused by the inability of the fertilized egg to move into the uterine cavity. With extensive damage to the tubes, prolonged dull pulling pains occur in the lower abdomen on the affected side.
Tubal obstruction can be unilateral or bilateral. In the first case, one tube is affected, and in the second, both. With unilateral obstruction, a woman retains the ability to become pregnant.
In both cases, the obstruction can be complete or partial, when the tube closes completely or partially. In case of partial obstruction, the sperm can penetrate the tube and fertilize the egg, but the fertilized egg does not pass into the uterus due to its size. Such obstruction often results in an ectopic pregnancy.
How to detect blocked tubes
Tubal obstruction is diagnosed using various tests:
- Hysterosalpingography (HSG), in which a radiopaque fluid is injected into the tube through a catheter. If the tubes are blocked, it is clear where exactly the blockage has occurred – this part of the tube remains dark on the X-ray. The procedure does not cause any significant pain, so anesthesia is not used. Sometimes a woman feels abdominal cramps.
- Echohysterosalpingoscopy is an ultrasound examination of the fallopian tubes. The procedure is similar to HSG, but more gentle, since sterile saline is used instead of a radiopaque substance. The pelvic organs are not irradiated during echohysterosalpingoscopy.
- Laparoscopy, during which a device called a laparoscope is inserted into the abdominal cavity. To do this, a small incision is made in the abdomen to insert the instrument. The doctor sees how passable the tubes are and determines the cause of the blockage (adhesions, adhesions, endometrioid foci).
Laparoscopy for tubal obstruction is considered the best option for diagnosis and treatment, as the doctor has the ability not only to detect the blockage, but also to eliminate it. During the procedure, adhesions are destroyed with a special instrument inserted into two additional micro-incisions on the abdomen. Laparoscopy is performed under anesthesia.
Treatment of obstruction
Obstruction of the fallopian tubes is treated using the following methods:
- Taking anti-inflammatory, absorbable drugs and prescribing physiotherapy procedures. It is possible to cure the disease without surgery if the inflammation and adhesions have started recently. Medicines help if the obstruction is not associated with adhesions, but with improper functioning of the tubes.
- Flushing (hydrotubation) or blowing (perturbation) of the tubes, when their patency is restored using water or air pumped under pressure. This method is used if the adhesions are located inside the tubes. The procedure is performed under anesthesia.
- Laparoscopy, which helps restore tubal patency surgically. A laparoscope (a device that allows you to examine the abdominal cavity from the inside) and a microinstrument, which is used to dissect adhesions, are inserted into the abdominal cavity through micro-incisions. Laparoscopy is performed under general anesthesia.
If it is impossible to restore tubal patency, IVF (in vitro fertilization) is performed, during which embryos are introduced directly into the uterus, bypassing the tubes.
