What Are the Pros and Cons of Fallopian Tube Surgery?

Fallopian tube fluid is injected into the uterine cavity from the cervix using melanin solution or normal saline. Then flow into the fallopian tube from the uterine cavity, and judge whether the fallopian tube is unobstructed according to the resistance when the medicinal solution is injected and the backflow of the liquid. Through the pressure of the liquid, the obstructed fallopian tube is restored.

Tubal fluid

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Fallopian tube fluid is a clinically popular method for tubal examination in the 1980s. Simple and easy to operate. It is injected into the uterine cavity from the cervix with melanin solution or physiological saline, and then flows into the fallopian tube from the uterine cavity, and judges whether the fallopian tube is unobstructed according to the resistance when the medicinal solution is injected. But it brings immeasurable harm to patients with tubal infertility.

Fallopian tube drainage is a surgical method used to diagnose the degree of tubal patency and treat some minor obstructions. Traditional tubal drainage has many hazards, causing problems for many patients and often misleading doctors. So, what are the harms of traditional fallopian tube drainage? First of all, the misdiagnosis rate is relatively high. After fluid drainage, the specific site of the obstruction and the severity cannot be determined, and the danger of fallopian tube rupture is very likely, which brings many difficulties to the treatment and also harms Women's health. And the harm of traditional fallopian tube fluid flow is more than that. Because the surgery is performed under invisible conditions, the internal details cannot be seen, many factors cannot be judged, the help for treatment is quite limited, and the requirements for the operator are extremely high, so if you are not careful Will hurt the patient's body and bring great pain.

(1)

Insufficient fallopian tubes After general treatment is unblocked, it is best not to conceive immediately, otherwise the phenomenon of ectopic pregnancy may occur. It is not advisable to use fallopian tubes for treatment when the fallopian tubes are not smooth. The peristaltic function of the fallopian tube increases the possibility of ectopic pregnancy. Fertility is a complex physiological process. Both spouses must have the following fertility conditions: 1. The ovary emits normal eggs; 2. The semen is normal and contains normal sperm; 3. The eggs and sperm can meet in the fallopian tube and combine to become a fertilized egg; 4. Fertilized eggs are successfully transported into the uterine cavity; 5. Endometrium is fully prepared for fertilized eggs to implant. If any of these links is abnormal, it can prevent pregnancy. The obstacles to conception may be the woman, the man, or both.

1. The patient's bladder lithotomy position after urination. The vulva and vagina are routinely sterilized, sterile towels are laid, and the uterine location and size are double-checked. Put a vaginal speculum to expose the cervix, disinfect the vagina and cervix again, clamp the front lip of the cervix with cervical forceps, insert the cervical catheter along the direction of the uterine cavity, and make it close to the external mouth of the cervix.

2. Connect the cervical catheter to the pressure gauge and syringe with a Y-shaped tube. The pressure gauge should be higher than the takeover level to prevent the injection from entering the pressure gauge.

3. The syringe is filled with 20ml of sterile normal saline (containing 80,000 units of gentamicin), and the injection should be slow. The pressure should not exceed 21.3kpa (160mmHg). If the fallopian tube is occluded, the patient will feel the lower abdomen swell when injecting 4-5ml Pain, at this time the pressure gauge saw that the pressure continued to rise but not decreased. If the fallopian tube is unobstructed, 20 ml of sterile normal saline is injected, without resistance, and the pressure is maintained below 8.0 kPa (60-80 mmHg). The patient has no abdominal discomfort. After the stagnation injection, the pressure rapidly decreases by itself, indicating that the injected fluid has successfully entered the abdominal cavity. Repeated tests, the situation is the same. You can also use a syringe to directly inject into the cervical catheter without using a pressure gauge. Anyone who was slowly injected with 20 ml of sterile normal saline without resistance, and the patient did not feel discomfort, confirmed that the fallopian tube was unobstructed. If you barely inject 10ml, you will feel resistance, and the patient will feel abdominal pain. After the bolus injection, the liquid will return to the syringe, which shows that the fallopian tube is occluded. If it can be advanced by pressurized injection, it means that the original mild adhesion has been separated. To identify which side of the fallopian tube is obstructed, place the stethoscope on the lower abdomen equivalent to the fallopian tube during the fluid flow. If you can hear the sound of fluid passing through the tubing, it indicates that the side tubal is unobstructed (but these are all conjectures, and their reliability Subject to certain limits).

4. After the operation, remove the cervical catheter, disinfect the cervix and vagina again, and remove the vaginal speculum.

The diagnosis rate of fallopian tube angiography is very high, it can check a lot of diseases, and can accurately judge, it is currently the most commonly used inspection method to understand whether the fallopian tube is unobstructed and the degree of unobstructed, and the specific blockage site. Its advantages are as follows:

1) The accuracy rate is as high as 98%: professional doctors are skilled in operating with digital X-ray machine application. Doctors can observe the relevant local conditions, display all soft tissues and activities, and diagnose related internal functions, clearly and accurately.

2) Wide range of applications: Fallopian tube angiography can be used to diagnose fallopian tube blockage, primary secondary infertility, abnormal uterine bleeding, patients with genital tumors, uterine malformations, uterine mediastinal adhesions, and foreign body blockage.

3) Safety and no side effects: under the operation of a skilled professional doctor, the tubal angiography has almost no damage, no sequelae and complications, and no side effects.

4) Therapeutic effect: Fallopian tube angiography is not only an examination method, but also has a therapeutic effect on certain infertility diseases, and no further treatment is necessary.

(1) Time selection: 3 ~ 7d after menstruation is clean, and 3 days before surgery

(1) Empty

(1) The fluid cannot pass

Although hysterosalpingectomy is widely used clinically for a long time because of the advantages of simple equipment, convenient operation, and low price, it also exposes the following disadvantages in long-term use:

1. Uterine fallopian tube drainage is the use of a catheter to inject liquid into the uterine cavity. The volume and surface area of the uterine cavity are much larger than the cross-sectional area of the catheter and fallopian tube cavity. According to the principle of fluid dynamics, the pressure is equal to the pressure of the area under stress. So the pressure of the injected fluid into the fallopian tube is very limited.

2. In actual clinical work, we also found that the rate of misdiagnosis of uterine fallopian tube drainage is high, reaching more than 50%. It is not possible to determine the location of the fallopian tube obstruction, the severity and nature of the fallopian tube obstruction, and the risk of causing massive bleeding like ectopic pregnancy.

3. Because the basic principle of hysterosalpingogram is basically the same as that of hysterosalpingogram. If the fallopian tube adhesion is light, it will be unobstructed by hysterosalpingography. If the hysterosalpingogram cannot restore the fallopian tube adhesion, then go through the uterus. Fallopian tube drainage also has no effect.

4. Uterine tubal drainage is a kind of blind communication. The specific process of the injected fluid in the patient's body cannot be seen during the drainage, so the location and nature of tubal obstruction cannot be clarified. This is important for determining the treatment method and efficacy of tubal obstruction. No help.

(1) Forbidden sex for 2 weeks after fluid flow to prevent infection.

(2) Anti-infective drugs should be taken after surgery.

(3) Abdominal pain may occur after surgery

1. Take anti-infective drugs after surgery.

2. Postoperative abdominal pain and vaginal bleeding may occur.

3. Sexual forbidden life within 2 weeks after fluid flow to prevent infection.

1. Unobstructed fallopian tube 20ml 0.9

1. The tubal fluid examination is widely used in the 1980s because of its simple equipment, easy operation, and low price. It is an old-fashioned operation. The principle is the same as the fallopian tube ventilation, except that sterile saline is passed in, and whether the fallopian tube is unblocked or not is estimated based on the change in pressure.

2. Fallopian tube fluid drainage has been widely used in clinic because of its simple operation and no special equipment, but because the accuracy rate is only 45% -50%, because it is a blind injection of fluid into the uterine fallopian tube, the fallopian tube may rupture during the operation. The risk of major bleeding like ectopic pregnancy has gradually been replaced by some advanced treatment techniques.

3. In addition, if severe abdominal pain occurs during hysteroscopic fallopian tube drainage, pay attention to whether the fallopian tube is ruptured. Generally, if the fallopian tube is inaccessible, when the injection of more than 10ml of fluid, there will be pain in the lower abdomen. In the syringe, the pain disappears, unlike the fallopian tube rupture. The operation is performed near the menstrual period. The endometrium is easily exfoliated and injected into the abdominal cavity. Long-term follow-up should be performed after the operation, and whether there is endometriosis. The same room and tub bath were prohibited for 2 weeks after the operation.

One is iatrogenic infection due to inadequate disinfection conditions, and the other is that repeated water flow can easily damage tubal function. The obstruction of the fallopian tubes is often caused by chronic inflammation. For patients who have caused severe adhesions, the fallopian tubes repeatedly have water. The adverse consequences are as follows: 1. Repeated application of antibiotics not only does not have an anti-inflammatory effect, but may also cause the spread of infection and affect the disease; 2. It may destroy the peristaltic ability of the fallopian tube and the ability to swing the cilia. Fertilized eggs rely on these two peristaltic functions to migrate to the uterine cavity for implantation; 3. Repeated water flow may also be the cause of hydrosalpinx. After hydrosalpinx appears, it is inevitable to affect the conception. In this way, it is equivalent to an additional treatment link than patients who do not have repeated water flow, which will increase the financial burden of the patient and bring unnecessary medical risks. .

What should I do if the tubal is bleeding?

Although tubal drainage is a convenient and quick operation, it is a gynecological operation after all. During the drainage process, it also passes through the patient's vagina, cervix and other sensitive berths. It is inevitable that the equipment used for the drainage will bring certain effects to these areas Trauma, therefore, bleeding after tubal drainage is still relatively common, and it is not an isolated phenomenon. In general, bleeding after tubal drainage will last three to seven days. If the time does not exceed seven days and the amount of bleeding is not large, no treatment is required and it will heal naturally. Once the amount of bleeding is large and lasts a long time, it is more abnormal, so you should go to the hospital for treatment.

Do tubal fluid pains?

Women who do tubal fluids can experience discomfort and cause a degree of pain.

Fallopian tube perfusion is a method of injecting fluid into the uterine cavity through a fallopian tube and indirectly judging the degree of tubal patency based on the amount of fluid and pressure. The tubal fluid examination was widely used in the 1980s because of its simple equipment and easy operation. It is a relatively old-fashioned surgery. With the continuous improvement of medical technology, it has been completely replaced by tubal angiography.

There are side effects of tubal drainage: if the fluid is taken under general anesthesia, nausea and vomiting, drowsiness, temporary inability to urinate, sore throat, headache, etc .; and some minor side effects such as muscle pain, Teeth, dentures cause lip, tongue injury, temporary dyspnea, speech difficulties, and nerve damage; or concurrent severe heart disease, stroke, severe allergic reaction, brain / lung damage, kidney / liver failure, permanent nerves Damage, eye injuries, throat damage, and pneumonia.

In addition, although tubal drainage is a sterile operation, because of the bacterial environment in the vagina, if the anti-inflammatory treatment is not kept up or sexually active after the fluid is passed, infection is very likely to occur; at the same time, the vaginal flow will inevitably affect the vagina. Bringing some trauma, may also bring side effects such as abdominal pain and vaginal bleeding.

Therefore, although the tubal drainage equipment is simple, convenient to operate, and low in cost, in view of the above-mentioned side effects of tubal drainage and with the continuous development of medical science and technology, tubal drainage has been abandoned by highly qualified hospitals and switched to A new COOK hysteroscopic fallopian tube recanalization technique. This technology can clearly see the entire fallopian tube treatment area under the guidance of television monitoring and salpingoscopy; then, a hairline-like interventional guide is guided by a coaxial catheter and inserted into the fallopian tube through the vagina, cervix, and uterine horn In the specific part where the obstruction occurs, the guide wire moves gently and slowly forward, so that the guide wire is injected into the fallopian tube through the catheter after the obstruction section, and selective fallopian tube obstructive treatment is performed, which is completely safe and painless. It can be carried out under simple conditions, with simple operation and light adverse reactions, which can achieve the dual purposes of diagnosis and treatment.