What to do if the left fallopian tube is blocked

We know that in order to successfully conceive a baby, a perfect combination of sperm and egg is required. However, many women are often troubled by some diseases. If the fallopian tube is blocked, it will seriously affect conception or even infertility. Because the fallopian tube is divided into the left and right sides, many women often have problems with one side of the fallopian tube, which will reduce the success rate of conception. Among them, the left fallopian tube is blocked, which is a problem encountered by many women. Let’s learn about what to do if the left fallopian tube is blocked?

What to do if the left fallopian tube is blocked

Laparoscopic examination and treatment of fallopian tube patency can only be performed after X-ray hysterosalpingography confirms that the site of fallopian tube obstruction is incomplete obstruction of the fallopian tube fimbria and there is suspected adhesion around the fallopian tube. Therefore, it is not recommended as a routine examination method. Usually, only when the cause of infertility cannot be determined by various conventional examination methods for patients with infertility, a routine fallopian tube perfusion examination (with methylene blue dye) is performed during endoscopic examination.

Hysteroscopy is a method of examination mainly used to understand the internal conditions of the uterine cavity. It can clearly understand the subtle lesions in the uterine cavity under direct vision through the combination of cold light source and endoscope. It is a microscopic examination, but it cannot understand the conditions of the fallopian tubes outside the uterine cavity. Because the fallopian tubes are a tubular structure extending from the edge of the uterus, they are located outside the uterus. Therefore, using hysteroscopy to check whether the fallopian tubes are unobstructed is the wrong place to use.

The combined examination of hysteroscopy and laparoscopy is used to check whether the fallopian tubes are unobstructed, but it also has great limitations, because hysteroscopy can only understand the situation inside the uterus, while laparoscopy can only understand the specific situation in the abdominal cavity and the tissue structure around the fallopian tubes and the presence or absence of adhesions, that is, the adhesion blockage at the fimbria of the fallopian tubes and the impact of adhesions around the fallopian tubes on the peristaltic function of the fallopian tubes. In other words, these two methods can only understand the situation at both ends and around the fallopian tubes, but there is no way to understand the specific blockage site and nature in the fallopian tube cavity. Understanding the patency of the fallopian tube cavity is the key to diagnosing and treating fallopian tube problems.

The correct diagnosis rate of whether the fallopian tubes are unobstructed by hydrotubation is very poor, and the misdiagnosis rate is as high as over 50%, because this method is only a blind examination.

Selective X-ray hysterosalpingography and recanalization can not only identify the specific site and nature of tubal obstruction, but also accurately understand the patency of the fallopian tubes. If tubal obstruction and partial stenosis are found, recanalization treatment can be performed at the proximal end of the fallopian tube. However, due to its high economic cost and the low-cost conventional X-ray hysterosalpingography, it is not recommended as the preferred examination method.

Fallopian tube endoscopy is an endoscopic examination instrument that performs a microscopic examination of the internal structure of the fallopian tube lumen. Through the fallopian tube endoscopy, local microscopic lesions inside the fallopian tube lumen can be directly observed, such as lesions of the fallopian tube mucosa and fallopian tube cilia immobility syndrome. Usually, this examination method is only used as an endoscopic examination to rule out infertility caused by abnormalities in the internal structure and function of the fallopian tube lumen when the cause of infertility cannot be determined after various infertility etiology examinations and laparoscopy. Usually, this examination method is only the last screening for the cause of fallopian tube in the etiology of infertility examination.

There is no ideal medical treatment for obstruction of the ampulla and fimbria. If the fimbria of the fallopian tube is adhered, a stoma can be made and the surrounding adhesions can be separated under laparoscopy or laparotomy. If the distal end is mildly obstructed, our experience is that we do not recommend excessive treatment. This is because mild obstruction indicates that the lesion is relatively mild, and the purpose of treatment is to make the lesion less severe. However, many of the current treatments for obstruction of the distal end of the fallopian tube are harmful and it is likely that the treatment will be worse than no treatment. Some hospitals advocate laparoscopic treatment, which we believe is not suitable because laparoscopy is traumatic, and the hemostasis and separation during laparoscopy are mainly electrocoagulation and burning, which may damage the fallopian tube tissue, cause new inflammation, and cause adhesion of the fimbria of the fallopian tube. Some hospitals also recommend intervention. According to our experience, intervention is only effective for the proximal end of the fallopian tube. It has no effect on the blockage or obstruction of the distal end. The fallopian tube intervention uses only an extremely thin guide wire with a diameter of about 1mm, so it is unrealistic to use such a thin wire to clear such a thick tube. In addition, the ampulla muscle layer is relatively thin and the mucosa is rich in blood vessels, so intervention is prone to perforation and bleeding. Third, the shape of the ampulla is tortuous while the guide wire is straight and cannot adapt to the local anatomical characteristics of the ampulla of the fallopian tube, so it is not suitable for interventional recanalization.

Currently, the only method that can truly cure the obstruction of the distal end of the fallopian tube is hydrotubation, but the effect is not ideal. There are two types of hydrosurgery: ordinary hydrosurgery, selective hydrosurgery by intubation under direct X-ray vision, or hydrosurgery under hysteroscopy. Using the power of water pressure to separate the adhesions of the fallopian tubes makes the fallopian tubes more unobstructed and reduces the occurrence of ectopic pregnancies. It can only be said that it plays a role in reducing the incidence but cannot completely avoid it. The special anatomical structure of the distal end of the fallopian tube means that there is no way to solve this problem well. Ordinary hydrotubation is the conventional fallopian tube perfusion we usually use. The water pressure of this method is relatively small, and the effect on distal obstruction is minimal. Since ordinary hydrotubation is a blind perfusion and the specific filling condition of the liquid in the fallopian tube cannot be seen, the patency of the fallopian tube after perfusion cannot be predicted, and there is an increased chance of infection. It should not be done too often. Its advantages are simple operation and low cost.

Through fluid insufflation under direct X-ray vision, also known as selective salpingography, the catheter is inserted into the fallopian tube under X-ray, and then the medicine is injected. The force is very strong, also called high-pressure injection. Because it is a direct operation under X-ray, we can clearly understand the patency of the fallopian tube after catheterization and fluid insufflation and can take pictures for observation, so we can control the injection pressure and speed at will. However, the disadvantage is that the cost is relatively high, 2,000 yuan, and the treatment effect is not very ideal.

Hysteroscopic fluid insufflation is a treatment method that involves inserting a catheter into the opening of the fallopian tube and injecting medicine. The force of the fluid insufflation is greater than that of ordinary water insufflation, but the lumen of the fallopian tube cannot be seen during the operation, so it is impossible to understand the treatment status during and after the operation, and it is impossible to control the pressure and speed of the fluid injection during the operation. Therefore, it cannot achieve the expected effect and is not recommended for medical use.

In addition, some hospitals also ask patients to undergo physical therapy, microwave, enema, and take traditional Chinese medicine. These treatments have a certain effect on inflammation of the fallopian tube, but they are useless for partial adhesions that have already occurred in the fallopian tube cavity, so they are not recommended. In addition, due to current technical reasons, endoscopic fallopian tube surgery has no therapeutic value for obstruction of the distal end of the fallopian tube.

Children are particularly important to every family. It is the existence of children that makes the family happier and warmer. Therefore, if you want to successfully conceive a healthy baby, you must eliminate all physical problems. The above is an introduction to what to do if the left fallopian tube is obstructed. If such a problem occurs, female friends must go to the hospital for examination and treatment in time.