Treatment of tubal obstruction
(1) Tubal implantation: including isthmus implantation and ampulla implantation in uterine cavity. Mostly used for proximal tubal atresia. Operation success rate (pregnancy rate) 10%? 50%。
(2) Tubal anastomosis: including interstitial anastomosis with isthmus or ampulla, isthmus anastomosis with isthmus or ampulla, ampulla anastomosis with ampulla or umbrella tip and various mixed anastomosis. The successful rate of recanalization after sterilization is the highest, about 50%? 90%。
(3) Tubostomy: used to treat distal tubal atresia. Atresia can be directly cut radially according to the original anatomical relationship or cuff eversion. 5% success rate? 30%。
(4) Tubal umbrella tip plasty: it is used to treat umbrella tip embedding, including umbrella tip expansion and/or separation, peritoneal adhesion incision and tubal wall incision. The success rate of surgery is 22%? 65%。
(5) Adhesion separation: There are many separation methods for adhesions around fallopian tubes and ovaries. The success rate of operation is 4 1%? 9 1%。
(6) Other plastic surgery: including electrocoagulation of endometrial lesions, excision of ovarian cyst or paraovarian cyst in fallopian tube, tubal clamp or ring removal used in sterilization and other different types of unilateral or bilateral fallopian tube surgery.
How to treat tubal obstruction with traditional Chinese medicine
Tubal obstruction can be divided into primary tubal obstruction and secondary tubal obstruction. The so-called primary tubal obstruction, that is, congenital, is present at birth, and this obstruction is extremely rare; Secondary tubal obstruction, that is, obstruction caused by acquired factors, is very common, caused by some disease factors and human factors, and is also the most important factor causing tubal obstruction. The secondary causes are mechanical and pathological. Mechanical tubal obstruction is caused by some fallen emboli and functional contraction of organs. Common emboli are endometrial fragments and blood clots during menstrual period. During medical abortion and induced abortion, the sudden release of uterine contraction and uterine pressure attraction during abortion makes embryonic tissues and embryonic appendages enter the fallopian tubes, resulting in tubal blockage.
The method and effect of traditional Chinese medicine in treating tubal obstruction mainly depend on the degree, location and nature of obstruction, as well as the fertility, age and requirements of patients. Traditional Chinese medicine in the treatment of tubal obstruction, according to the symptoms are divided into different types. The common types are: damp-heat and blood stasis blocking liver stagnation and qi stagnation blocking cell pulse cold and blood stasis blocking yin deficiency and blood stasis.
According to the above types, the methods of clearing heat, promoting diuresis and dredging collaterals, soothing the liver and regulating qi and dredging collaterals, activating blood circulation and dredging collaterals, activating blood circulation and dispelling cold, nourishing yin and activating blood circulation and dredging collaterals can be adopted respectively. Syndrome differentiation is the key to treat this disease.
Traditional Chinese medicine is only an adjuvant therapy for tubal obstruction, and the effect of using traditional Chinese medicine alone is not good. Patients with tubal obstruction need to find out the reason first, because the fallopian tube can be caused by infection, cyst and other factors, and also need to find out whether the obstruction is near, middle or far. The causes are different and the treatment methods are different. The corresponding treatment methods include interventional therapy under color Doppler ultrasound, liquid drainage, combination of traditional Chinese and western medicine and hysteroscopy and laparoscopy. What kind of treatment should be adopted? You need to check and work out the corresponding treatment plan according to your personal situation.
How to diagnose tubal obstruction?
1, ultrasonic inspection
Ultrasound examination of fallopian tubes includes general ultrasound examination and ultrasound drainage. Ordinary examination, ultrasound can detect part of hydrosalpinx, which shows that there are thickened liquid dark areas on both sides of uterus, but ultrasound can not diagnose hydrosalpinx or ovarian cyst, only hydrosalpinx, suggesting the possibility of hydrosalpinx.
2, hydrosalpinx
Tubal drainage, also known as tubal drainage, is to insert a tube into the uterus of the subject, and then inject 20ml of liquid medicine through the tube, usually saline plus antibiotics.
3.x-ray hysterosalpingography
X-ray hysterosalpingography can show the size, shape and position of uterine cavity and the shape of fallopian tube from fluorescent screen and X-ray photos.
4. Laparoscopy
If the proximal fallopian tube is blocked (fallopian tube interstitial part and isthmus), methylene blue solution cannot flow into abdominal cavity through the umbrella end of fallopian tube; If the distal fallopian tube is blocked (ampulla and ampulla of fallopian tube), it can be seen that the umbrella end and ampulla of fallopian tube expand, thicken and stain blue, but no methylene blue solution flows out from the umbrella end of fallopian tube and into abdominal cavity.
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