Treatment of tubal obstruction 1, drug therapy
Salpingitis, which causes tubal obstructive infertility, is mainly chronic inflammation, so it is often treated with drugs, especially the prescription of regulating menstruation and dredging eggs, which has excellent effect.
2. Surgical therapy
(1) Tubal hydrotubation: It can be performed after 3 days of clean menstruation. Add 1.6 million units of gentamicin, 2ml of 2% procaine and 5mg of dexamethasone. -5 mg chymotrypsin was dissolved in 20 ml physiological saline and injected into uterine cavity through fallopian tube catheter. Every other day 1 time, stop taking drugs before ovulation. Can be used for continuous treatment for 2-3 menstrual cycles. At present, this therapy is still adopted by most medical institutions, but the curative effect is poor and the false positive rate is high.
(2) Conventional surgical treatment: salpingostomy, adhesion separation, salpingostomy, hysterosalpingostomy, etc. Conventional surgery has a large incision and slow postoperative recovery.
The normal function of fallopian tube plays an important role in pregnancy. The fallopian tube can capture mature eggs discharged from the ovary into the membrane cavity. It also provides a channel for sperm to ascend, so that sperm can meet eggs in the ampulla of fallopian tubes and fertilize them.
It also provides the best internal environment for the division and differentiation of fertilized eggs. The rhythmic peristalsis of fallopian tube can send pregnant eggs into uterine cavity for implantation. If the fallopian tube is blocked by pathological changes, it will lose all the above functions and cause infertility. Tubal disease is an important cause of infertility, accounting for 25% of the causes of infertility, of which obstruction is the most common.
There are several possibilities for tubal patency: the basic conditions for pregnancy are met, at least there are no roadblocks and no potholes on the road. You can continue to investigate other reasons and continue to try to get pregnant.
Poor contact: There is a problem. It may be that the fallopian tube cavity is a little sticky, the road is overgrown with weeds, or the road with a slightly twisted fallopian tube is not so easy. In this case, you can try to be pregnant for 3-4 months, but you can't take late treatment.
Passing but extremely poor: This is based on passing but extremely poor, and the lesion is more serious. It is recommended to have treatment before trying to get pregnant.
Basically impassable or blocked: in theory, no matter where the fallopian tube is blocked, it means that sperm and eggs cannot meet. However, everything is not absolute. Sometimes people are too nervous during radiography, and the fallopian tube will spasm locally. The film may look like blockage, especially at the proximal end, because the isthmus of fallopian tube is narrower and thinner, which makes it easier to spasm.
If it is really blocked, it depends on the degree of congestion. The fallopian tube is a tube about 10cm long. If there is only a little blockage or a long blockage in the middle, it can't be distinguished under radiography. So even if it is blocked, there is a certain probability to try treatment and get through. Of course, most of the results still don't work.
Adhesion of umbrella tip or pelvic cavity: If there is a problem with the diffusion of contrast agent at the umbrella tip of fallopian tube, it will also affect pregnancy, so it is not easy for eggs to enter the lumen through the door of fallopian tube. Most of these cases need laparoscopic surgery.
Causes of tubal obstruction 1. Gynecological inflammation.
Inflammation of pelvic cavity and urogenital tract is the chief culprit of tubal obstruction. Such as mycoplasma infection, chlamydia infection, gonococcal infection, cervicitis, endometritis and adnexitis. If not treated in time, when inflammation spreads to the fallopian tube, it will lead to fallopian tube blockage.
2. Surgical infection
Infection after uterine cavity, pelvic cavity and abdominal cavity operation.
Female genitalia is not an independent and isolated system. There are many organs adjacent to fallopian tubes in the pelvic cavity alone. Inflammation of any organ in the pelvic cavity may involve fallopian tubes. Infection after intrauterine, pelvic and abdominal surgery is also a major cause of tubal obstruction.
If disinfection is not strict, or the original reproductive system is chronic inflammation, it may cause postoperative infection, or the operation is not standardized, or the personal hygiene and doctor's advice are not paid attention to after operation, it may cause inflammation, thus affecting natural pregnancy. Therefore, in order to ensure the patency of fallopian tubes, we must pay attention to anti-infection treatment after intrauterine operation or after operation, even if it is abdominal surgery far away from fallopian tubes.
3. Intrapelvic adhesion
This usually covers the ovaries and the ends of the fallopian tubes, or adheres the fallopian tubes to other tissues. Especially for women who have undergone pelvic surgery, most of them will have adhesion problems.
4. Infection caused by abortion
After abortion or childbirth, the body's resistance is weakened, and the dilated cervix is not completely closed, so the bacteria in the cervix may infect the pelvic cavity. If the postoperative disinfection is not strict or the anti-infection treatment is not paid attention to, it is easy to cause germs to enter the fallopian tube, thus causing the fallopian tube to adhere and block.
5. Tuberculosis? tubal tuberculosis
Mycobacterium tuberculosis is different from other pathogens, it can spread to reproductive organs through blood and lymphatic channels, and fallopian tube is the most susceptible part of tuberculosis in reproductive organs.
Tuberculous salpingitis is usually a chronic disease. Once blocked, it is difficult to get through without surgery. Even if the operation is reopened, the pregnancy rate is very low. Therefore, tuberculosis must be prevented as much as possible, and BCG should be vaccinated from an early age. Once infected with tuberculosis, standardized treatment should be carried out to prevent germs from spreading to fallopian tubes and causing tubal tuberculosis. If the diagnosis is tuberculous tubal obstruction, it is suggested to do anti-tuberculosis treatment first.
6. Endometriosis
Some women with particularly severe dysmenorrhea are very painful because their menstrual blood circulation is blocked. On the one hand, the uterus contracts strongly, which will cause severe pain. On the other hand, the strongly contracted uterus will push off the endometrium or blood clot to the fallopian tube, resulting in endometriosis. This is a physiological and mechanical blocking method.
7. Congenital tubal dysplasia
This is a very rare phenomenon. Such as congenital absence or deformity of fallopian tube, too long fallopian tube or narrow lumen, too tortuous fallopian tube, etc. These problems can't be prevented, and mother's dream can only be realized by surgery or IVF.
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