OBSTRUCTION OF TUBES

Occlusion of Tubes:

In the female genital system, the structure extending in the form of a hollow tube that opens to the uterus and the other end to the ovaries is called the fallopian tubes. A significant portion of female infertility cases are due to blockages in these tubes.

The inner wall of the tube may be clogged, the outer part may be adhered to the surrounding tissues, or the ciliary cells lining the inner part may not be functioning. Since pregnancy first occurs in the tubes, if the tubes are clogged, the egg cannot pass into the tube, or even if it does, the sperm cannot reach the tube and fertilize the egg due to the defect in the tube. In some cases, even if fertilization occurs, the embryo cannot reach the uterus and remains in the tube, and in this case, an ectopic pregnancy occurs.

The most common cause of obstruction in the tubes is genital infections. Generally, the source of infection can be previous pelvic infections, sexually transmitted infections, spiral use, miscarriage or postpartum infections. The previous intra-abdominal surgeries of the patient may cause adhesions in the tubes. Especially perforated appendicitis can cause this. Having had an ectopic pregnancy before also increases the risk. In cases of chocolate cyst (endometriosis), blockages may also occur in the tubes. Occlusion in the tubes usually does not give any symptoms.

How is the diagnosis made?

Obstruction can be seen in one or both of the tubes in patients whose uterine film is requested, mostly because they do not have children. With a careful ultrasonographic examination, tubes with significant fluid accumulation also help to make the diagnosis.

Uterine Film (HSG)

Uterine Film (HSG) is an X-ray that displays the uterus and tubes. In a normal x-ray, the uterus and tubes cannot be seen, a special liquid is given from the cervix to make them visible, and an x-ray is taken during this time. Thus, information is obtained about the structure and permeability of the uterine walls and tubes. Pathologies related to the inner wall of the uterus and problems related to the tubes can be revealed with HSG. HSG extraction takes about 15-20 minutes and usually a pain like menstrual pain is felt. In order to avoid any pain, shooting can also be done with anesthesia. Antibiotics can be given beforehand to prevent infection after HSG extraction.

Laparoscopy

Sometimes, in doubtful cases, laparoscopy (looking into the abdomen with a camera) may also be applied to make a definitive diagnosis. During laparoscopy, the passage of a liquid (usually methylene blue) given from the cervix through the tubes can be controlled and thus, if there is an obstruction on the inner surface of the tubes, it can be detected. In some cases, it is not possible to restore the tubes and the tube is either removed or disconnected from the uterus.

If the tubes are clogged and cannot be opened, including in microsurgical methods, it is possible to have a child with IVF.