Blocked Fallopian Tubes: Is Laparoscopic Surgery for Clearance Necessary?
A blocked fallopian tube is a blockage in the passageway of the fallopian tube, which is the same thing as a blockage in a blood vessel or lymphatic vessel. The fallopian tubes and the ovaries are known as the "uterine appendages." The fallopian tubes have two main functions: One is for picking up eggs, and the other is for providing a place for the sperm and egg to unite, that is, the juxtaposition of the fallopian tube.
Fallopian tube blockage is one of the common clinical causes of infertility. Many women wonder why the fallopian tubes get blocked so easily. How can they be so fragile? In fact, the fallopian tube, in a sense, is fragile, and its physiological structure makes it can't stand any toss.
Because the fallopian tubes are relatively narrow, they can usually only fulfill the combination of sperm and egg. In addition, the fallopian tubes are already thin, so there are often infertile women due to fallopian tube blockage in clinical practice. There is one fallopian tube on each side of the uterus, and one or both can be blocked.
Surgery is the mainstream method for unblocking the fallopian tubes. Compared with medication, surgery can unblock the fallopian tubes. At the same time, it is convenient for the doctor to observe whether other lesions in the fallopian tubes can be handled together, thus avoiding the phenomenon of not getting pregnant after treatment due to other reasons. Laparoscopic surgery is one of them.
Laparoscopy is a minimally invasive surgical procedure in which 3-4 small holes with a 0.5-1.0 cm diameter are usually made in the abdominal wall. Then the surgeon uses endoscopes and precision surgical instruments to operate in the pelvic and abdominal cavities. The endoscope has a magnifying effect and can clearly show the surgical site. Laparoscopy is the preferred surgical procedure in reproductive surgery.
So, in what cases do blocked fallopian tubes require laparoscopic surgery?
In fact, we usually consider the need for laparoscopic surgery based on the woman's age, ovarian function, medical history, years of infertility, and the location or status of the tubal blockage, considering all circumstances.
According to age and ovarian function
Laparoscopic surgery may be considered if the woman is young, has normal ovarian function, has been infertile for less than 2 years, and has distal tubal blockage and adhesions.
Laparoscopic surgery is not recommended if the woman is young but has diminished ovarian reserve, even if the infertility period is shorter than 2 years and the tubal blockage and adhesion are distal. If a woman insists, note that the ovaries must be protected during the procedure.
Laparoscopic surgery is not recommended if the woman is older or over 40, regardless of normal or diminished ovarian function.
Assessment of medical history and years of infertility
If a woman has a history of tubal pregnancy, one side of the fallopian tube has been removed or conservatively treated, and one side is open but not smooth. There is no pregnancy for more than two years after the ectopic pregnancy, which indicates that the other side of the fallopian tube is not functioning properly. Even if laparoscopic surgery is performed, the chances of a pregnancy after the surgery are very low, so laparoscopic surgery is not recommended.
If a woman has had a history of tuberculosis and the imaging shows blocked or partially obstructed fallopian tubes with rigid or beaded changes, this indicates that the tuberculosis bacteria have invaded the tubes. Even if the angiogram shows patency, the tubes may not function normally, so laparoscopic surgery is not recommended either.
The site of tubal blockage or adhesion
If the patient has an occluded uterine horn intertidal tubal obstruction, laparoscopic surgery at this time is usually ineffective. Laparoscopic surgery is recommended if the tubes are distally adherent with fluid accumulation to separate the adhesions and remove the fluid, which will help the embryo to settle whether you try to conceive on your own or undergo IVF.
If the patient's fallopian tubes are open but not smooth, distally uplifted, and positioned far from the ovaries, then she can have a laparoscopic procedure to separate adhesions and position the umbilical ends of the tubes if she is otherwise normal.
In conclusion, whether to do laparoscopic surgery or not, patients need to be evaluated by the doctor in conjunction with the comprehensive assessment. It is recommended to go to the hospital promptly to diagnose and follow the doctor's arrangements. And remember, medication is still the first choice. The traditional Chinese medicine Fuyan Pill helps eliminate symptoms in patients and cures the disease without causing adverse effects on the body. Surgery should be the last choice.
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