What Are Blocked Fallopian Tubes?

Fallopian tube obstruction is mostly caused by infections, common bacterial infections, and special pathogen infections, such as tuberculosis, chlamydia trachomatis, ureaplasma urealyticum, mycoplasma hominis, and protozoa. According to the site, it is divided into proximal tubal obstruction, middle tubal obstruction and distal tubal obstruction. According to the degree of obstruction, there are fallopian tube obstruction and complete fallopian tube obstruction.

Basic Information

English name: salpingemphraxis
Visiting department: Gynecology
Common causes: Gynecological inflammation, induced abortion, long-term vaginal bleeding, unclean sex, etc.

Common symptoms: Infertility
Contagious: no

Causes of tubal obstruction

Gynecological inflammation

Such as vaginitis, cervicitis, uterine inflammation, appendicitis, pelvic inflammatory disease and other gynecological inflammation, often due to these gynecological inflammation has not been treated in time or incomplete treatment, the condition is continuous. Owing to the long-term inflammatory stimulation, the fallopian tubes become congested, edema, thickened, hardened, the lumen adhered, and narrowed until they are blocked, resulting in tubal obstructive infertility.

2. abortion

Induced abortion is the main cause of tubal obstruction. Due to various reasons such as mechanical stimulation, improper operation or incomplete abortion during abortion surgery, various inflammatory infections are often caused; with the invasion of various pathogenic bacteria, they spread from the uterus to the fallopian tubes and pelvic cavity, leading to infection of the fallopian tubes. Causes fallopian tube obstruction.

3. Long-term vaginal bleeding

Irregular vaginal bleeding often occurs due to gynecological tumors, ovarian dysfunction, uterine lesions, etc., due to excessive menstruation, excessive menstrual periods, endless menstruation, or even menstruation twice a month. Without timely treatment, over time, secondary Inflammation and infection lead to festering, adhesion, and blockage of the inner wall of the fallopian tube.

4. Unclean sex life

Unclean sex is the cause of many diseases. Patients often infect various diseases such as gynecological diseases and sexually transmitted diseases due to unclean sex life. These diseases may cause secondary fallopian tube inflammation, resulting in tubal obstruction to varying degrees and infertility.

5. Other factors

Such as fallopian tube endometrial displacement, abdominal surgery, appendicitis surgery, access to the birth control ring, pelvic tuberculosis, etc., can cause fallopian tube infection, leading to fallopian tube wall congestion, edema, adhesions and blockage.

Clinical manifestations of tubal obstruction

Generally speaking, there are no typical symptoms, and the most common manifestation is infertility. The fallopian tube plays an important role in transporting sperm, ingesting eggs and fertilized eggs to the uterine cavity. The blocked fallopian tube prevents the passage of sperm and fertilized eggs, leading to infertility or ectopic pregnancy. If it is tubal obstruction caused by pelvic inflammation, it can be accompanied by lower abdominal pain, low back pain, increased secretions, pain during intercourse, and so on.

Infertility

The fallopian tube itself is damaged by the disease, causing obstruction and infertility.

Dysmenorrhea

Congestive dysmenorrhea due to pelvic congestion, most often have abdominal pain starting 1 week before menstruation, and the heavier it is near the menstrual period, until the menstrual cramps.

3. Other

Such as increased vaginal discharge, pain during sexual intercourse, gastrointestinal disorders, fatigue, labor affected or endurance, mental and neurological symptoms, and depression.

4. Abdominal discomfort

The lower abdomen has different degrees of pain, mostly recessive discomfort, soreness, swelling, and falling sensations in the lower back and crotch, often exacerbated by fatigue. Due to pelvic adhesions, there may be pain in the bladder, rectum, or pain during emptying, or other bladder and rectum irritation symptoms, such as frequent urination and relapse.

5. Irregular menstruation

The fallopian tube is adjacent to the ovary. Generally, diseases of the fallopian tube do not affect the function of the ovary and have no effect on the amount of menstruation. Only when the inflammation spreads to the ovaries and causes damage to the ovarian function will the abnormal menstruation occur.

Fallopian tube obstruction

Tubal fluid

Use melanin solution or physiological saline to inject into the uterine cavity from the cervix, and then flow into the fallopian tube from the uterine cavity. According to the resistance when the liquid is injected, the fallopian tube is judged to be unobstructed. Because of the advantages of simple equipment, simple operation, and low price, the method of tubal fluid examination was widely used before the 1980s. However, because the entire process relies on the subjective judgment of the doctor and can not determine the position of the blocked fallopian tube, the tension during the inspection process can cause tubal spasm and cause false positives. In recent years, surgery can be performed under ultrasound monitoring to improve the accuracy rate, but However, in practice, it is found that this method has a high misdiagnosis rate, so it is not an ideal test.

2. Hysterosalpingography

It has been used since the 1920s. It is used to inject contrast agents (such as iodine, diatrizoate, etc.) into the uterine cavity through the cervical canal. Visualization and observation of the degree of diffusion of the contrast agent can reveal tubal occlusion, fallopian tube motor function, mucosal damage caused by previous infection or fallopian tube endometriosis, hydrosalpinx, tubal isthmus nodules, adhesions and tubal abnormalities And diverticulum), a quick, economical, and low-risk examination. Hysterosalpingography is 65% sensitive to tubal occlusion and adhesions, but tubal spasm caused by pain can cause false positives, and pain, infections, and invasion of contrast agents into the vascular system are rare complications.

3. Fallopian tube

A method for imaging the lumen structure of the fallopian tube, which needs to be applied to a soft fallopian tube during inspection, which can evaluate the entire length of the fallopian tube and the mucosa and patency of the fallopian tube during the inspection process. General surgery, therefore has a potential therapeutic effect on proximal tubal obstruction, but salpingoscopy has high requirements on technology and equipment, so it is not widely used at present. In addition, salpingoscopy can also enter the abdominal cavity through a transvaginal laparoscopic route. .

4. Laparoscopy

Inject meilan into the uterine cavity through a uterine catheter, and observe the laminoscope's overflow of the fallopian tube to the pelvic cavity through the umbrella end, which is unobstructed; if the proximal fallopian tube is blocked (tubal interstitial and isthmus), no melanin can be seen The umbrella end of the fallopian tube overflows into the abdominal cavity. If the distal end of the fallopian tube is blocked (the ampulla and the umbrella part of the fallopian tube), it can be seen that the umbrella end and the ampulla of the fallopian tube are enlarged and blue-stained, but no beautiful blue fluid flows from the fallopian tube umbrella end and flows into the abdominal cavity. Laparoscopy can directly look at the tubal obstruction and the surrounding adhesion and can treat the adhesion at the same time. It is the gold standard for diagnosing tubal obstruction, but it requires general anesthesia and surgical treatment. It is currently not commonly used and is only used for tubal drainage. Or patients who have abnormalities in the fallopian tubes and require surgery.

Diagnosis of tubal obstruction

A diagnosis can be made based on the cause combined with appropriate laboratory tests.

Complications of tubal obstruction

Infertility

The fallopian tube plays an important role in transporting sperm, ingesting eggs, and delivering fertilized eggs to the uterine cavity. When the fallopian tube is damaged by a disease, it forms an obstruction, hinders the passage of sperm and fertilized eggs, and causes infertility.

2. Irregular menstruation

The fallopian tube is adjacent to the ovary. When the fallopian tube inflammation spreads to the ovaries, it will cause ovarian function to be damaged to varying degrees, thus causing abnormal menstruation. Among them, frequent menstruation and excessive menstrual flow are the most common.

Tubal obstruction treatment

No specific treatment.

Drug treatment

Salpingitis that causes fallopian tube obstructive infertility is mainly chronic inflammation, so most of them are treated with drugs, especially traditional Chinese medicine Tiao Jing Tong Yu Fang, with poor curative effect.

2. Surgical treatment

(1) Fallopian tube drainage can be performed 3 days after menstruation is clean. 160,000 units of gentamicin, 2 ml of 2% procaine, 5 mg of dexamethasone, and 5 mg of -chymotrypsin were dissolved in 20 ml of physiological saline and injected into the uterine cavity through a tubal catheter. Once every other day, stop treatment before ovulation. Can be treated continuously for 2 to 3 menstrual cycles. This therapy is still used by most medical institutions, but it has poor efficacy, is susceptible to infection, and has a high false positive rate.

(2) Routine surgical treatment for tubal ostomy, adhesion separation, tubal anastomosis, uterine tubal implantation and so on. Conventional surgical incisions are large and recovery is slow after surgery.

(3) In vitro fertilization-embryo transfer can be performed for those who have fertility requirements. If there is no discomfort and fertility requirements, no special treatment is required.