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Treatment of obstruction of the fallopian tubes and microsurgical operations

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Treatment of obstruction of the fallopian tubes and microsurgical operations

Treatment of obstruction of the fallopian tubes and microsurgical operations

Fallopian tubes are hollow organs through which the egg moves from the ovary to the uterine cavity. This process is provided by peristalsis, while the cilia of the epithelium lining the tube from the inside move towards the uterus. Obstruction of the fallopian tubes causes infertility. This factor accounts for about half of the cases of impaired fertility. Another danger, especially with partial obstruction, lies in the increased risk of ectopic pregnancy.
Symptoms in most cases are absent, even in the presence of an inflammatory process. Only with a pronounced exacerbation can nonspecific signs appear:

- pain in the lower abdomen, mainly from the side of the lesion;

- bloating, constipation or, conversely, diarrhea;

- violation of the menstrual cycle;

-frequent urination;

- Pain during intercourse.

In 60% of cases, obstruction of the fallopian tubes is caused precisely by inflammatory processes. As a result of this, there is a gradual destruction of the ciliated epithelium, which leads to sticking of the fimbriae and scarring. The shape of the organ is significantly deformed, saccular protrusions filled with fluid (hydrosalpinxes) appear. The mechanism for moving a fertilized egg into the uterine cavity is disrupted. If the tubes are partially clogged, the risk of ectopic pregnancy increases, if completely - tubal infertility. Obstruction of the fallopian tubes is often almost asymptomatic. The survey begins most often about the impossibility of spontaneous pregnancy. At the primary stage, the gynecologist evaluates the ovulation and spermogram of the husband, and at the secondary stage, the patency of the fallopian tubes. After the tubal-peritoneal factor is identified, examinations are carried out to determine the most likely cause.

TREATMENT

Conservative treatment is effective only at the very beginning of the pathological process (it is possible to stop inflammation and lyse tender adhesions). The operation is performed when the tubes are deformed by microsurgical methods for the most accurate restoration of the anatomy. With the failure of all measures for the onset of pregnancy, IVF is recommended.
Surgical correction, which involves the implementation of laparoscopy in order to eliminate the adhesive process, localized foci of inflammation, various neoplasms of the pelvic organs, as well as reconstructive plastic surgery. These operations are indicated only in non-started cases, when there are single adhesive processes, partial obstruction of the tubes, and there is also regular ovulation and the fertility of both spouses is at a fairly high level.

IVF (in vitro fertilization) technique, which allows to achieve pregnancy with complete obstruction of the fallopian tubes.

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