Fallopian tube is blocked, is it useful to take medicine? Need surgery?

Fallopian tube is the only way for sperm and egg to meet during natural conception. When the fallopian tube is affected by inflammation, pelvic local diseases and other factors, adhesion, water accumulation and obstruction will occur, hindering sperm and egg to meet, thus causing infertility.

Many people will ask the doctor when they find that there is a problem with the fallopian tube during the examination: “Can my condition be cured by taking medicine?” ]

As pelvic inflammatory disease is the main cause of fallopian tube diseases, it is true that some fallopian tube problems are treated with drugs, but antibiotics are generally only used for drug treatment when inflammation is acute.

If the fallopian tube has been damaged by pathological changes, the significance of antibiotic treatment is not great. At this time, surgical treatment or direct IVF should be selected.

Check first, then operate

Before selecting a specific operation method, it is necessary to find out the location and degree of fallopian tube lesions through hysterosalpingography and other examinations, for example, to know whether it is proximal obstruction or distal obstruction, whether there is water accumulation, and the cause of fallopian tube lesions is what, etc. (If it is tubal obstruction caused by Mycobacterium tuberculosis infection, surgery is not recommended)

If pelvic surgery has been performed before, the doctor will refer to the previous surgery to judge whether it is necessary to perform another surgery.

In addition, if the woman is older, the ovarian reserve function is poor, or the man has severe oligospermia or asthenospermia, it is not suitable for surgery, and IVF can be directly considered.

Different situations, different operations

The following is an introduction to the following two common surgical therapies:

First, the treatment of distal tubal obstruction

1. Tubal adhesion separation and salpingostomy

At present, laparotomy has been basically eliminated, and laparoscopy is generally used. At the same time of doing laparoscopy, pelvic adhesion can also be checked and adhesion separation can be carried out.

As for whether pregnancy can be achieved after surgery, it is related to the shape and physiological function of fallopian tubes, as well as the degree of pelvic adhesion, so the specific situation should be judged by a doctor.

2. Tubal resection and ligation

Looking at the name, we know that this kind of operation will completely block the fallopian tube, so it is only suitable for patients with severe hydrosalpinx, serious damage to the structure of the fallopian tube, loss of basic function of the fallopian tube, and less possibility of surgical recovery.

As inflammatory factors in hydrosalpinx will flow back into the uterine cavity, which has toxic effects on sperm and fertilized eggs, the incidence of embryo implantation will also be reduced after the intima is stimulated by inflammation.

Therefore, for the case of serious hydrosalpinx and loss of function of fallopian tubes, IVF is usually done directly after ligation or resection of fallopian tubes.

2. Treatment of Proximal Tubal Obstruction

1. Tubal anastomosis

This method is especially suitable for women with tubal ligation, because most of them have no pathological changes in the tubal itself and have a greater chance of pregnancy after operation.

2. Interventional therapy

Interventional therapy is guided by hysteroscopy and ultrasound. Tubal catheter is combined with very thin endoscopic fibers, which can directly look at the lumen, separate adhesion and eliminate obstruction.

This method is most suitable for women with proximal tubal obstruction and the rest is normal. If distal tubal obstruction is combined at the same time, it is not suitable for this treatment.

According to the situation of tubal lesions, the above treatment methods can also be selected in combination. For example, if infertility is caused by severe tubal hydronephrosis, [proximal tubal ligation plus distal tubal ostomy or resection] can be adopted to reduce the adverse effects of tubal hydronephrosis on embryos and endometrium and improve the success rate of IVF.

Finally, I would like to remind you that the best pregnancy time (natural conception) after surgery is usually within 6 months. If you are not pregnant for more than 1 year after surgery, you should consider being a IVF.