Endometriosis affects nearly 10% of women during their reproductive years and is a major cause for infertility. This gynecological condition occurs when the tissue lining the uterus (endometrium) grows outside the uterus. The endometrium then grows on the ovaries, fallopian tubes and outer surface of the uterus and even sometimes on the bladder, bowel, intestines, colon, vagina, cesarean and laparoscopy scars. This endometrial growth does not get regularly sloughed off with the menstrual cycle and keeps building up to form ovarian cysts. In fact endometriosis can even cause distortion of a woman's internal anatomy. While the theory of retrograde menstruation holds that some menstrual blood flows back through the fallopian tubes and grows there, it is not yet fully substantiated yet. Some women have a genetic predisposition to endometriosis. The role of immune system dysfunction and environmental influence on endometriosis is also being studied.
Severe pelvic pain is the characteristic symptom associated with endometriosis. This pain is felt while passing urine, during sexual intercourse and during ovulation. A woman suffering from endometriosis may notice heavy irregular bleeding and abdominal bloating. Infertility is noticed in more than 40% of women suffering from endometriosis. A pelvic examination is conducted on a woman complaining of symptoms of endometriosis. It can reveal the presence of tender nodules in the ovary regions or the posterior vaginal wall. Pelvic ultrasound is used to locate endometriosis areas. Laparoscopy can aid in checking pelvic organs for endometrial tissue. It gives a clear idea of the extent and location of endometriosis.
Hormone therapy is advocated by some as treatment against endometriosis. Birth control pills or progestins are often prescribed. This may help in tempering the estrogen production and relieving some of the signs and symptoms of endometriosis. Progesterone pills or injections can be used to treat endometriosis. The drug Danazol is also sometimes prescribed. Anti-gonodotropins produce a psedomenopausal state and can relieve some of the problems associated with endometriosis. But treatment of endometriosis with drugs is limited to about six months or so to prevent a detrimental effect on bone density. Laparoscopic surgery is yet another endometriosis treatment advocated by some doctors. The surgeon aims at removing all endometriosis lesions, cysts and adhesions. This is done is severe cases of endometriosis and infertility.
Metrorrhagia is dysfunctional uterine spotting or bleeding between menstrual cycles. This erratic bleeding can occur due to various reasons and can be inconvenient and worrying. Typical causes for Metrorrhagia include endometriosis, hormonal fluctuations, polyps, fibroids, cervical cancer and Adenomyosis. Often an ectopic pregnancy can lead to such irregular spotting. Women who are on the IUD might notice such irregular bleeding in case the contraceptive has shifted. Mid-cycle bleeding can occur sometimes during ovulation. Other causes include trauma and sexually transmitted diseases. Acute or excessive alcohol consumption and cigarette smoking can shorten menstrual cycles. In many cases, no medications are necessary for Metrorrhagia. Oral contraceptive pills are often prescribed to treat irregular bleeding. They help in regulating the menstrual pattern. Lifestyle modification might help in some cases.
Oviduct blockage is the blockage in one or both microscopic fallopian tubes that allow a woman's egg to pass from her ovaries to her uterus. The blockage is an impediment for the egg to migrate, implant and begin pregnancy. The result is infertility. In rare cases, even if pregnancy occurs it can be dangerous, if not treated immediately.
Diagnosing oviduct blockage
Laparoscopic chromotubation: Usually done after sedating with a mild anesthetic, laparoscopy involves making a very small incision in the belly button and near the pubic bone area; a small camera helps view the tubes. Laparoscopy helps detect endometriosis, adhesions, and ovarian cysts and also check the tubes.
Chromotubation involves infusing diluted methylene blue dye solution into the uterine and tubal lumen. If the tubes are not blocked, the dye should come out of the ends of the tubes into the peritoneal (abdomen) cavity. This test is considered the most reliable way to determine oviduct blockages.
Both laparoscopic chromotubation and Hysterosalpingogram can sometimes open a blocked tube; hence these procedures can be both diagnostic and therapeutic. The rate of fertility is likely to improve after the procedure.
Falloscopy: The newest form of endoscopic examination, falloscopy is helpful to look inside the fallopian tubes. Using a catheter-based system, a flexible tube is inserted through the vagina and cervix which threads through one of the fallopian tube. Very similar to hysterosalpingogram, it allows viewing of tubal walls and checks if it is healthy and also detects obstruction, if any.
Sonohysterography: This is a non-invasive procedure wherein fluid is injected through the cervix into the uterus, and ultrasound imaging is used to determine if any abnormality is present. The procedure is extremely helpful in detecting underlying cause of many problems such as abnormal uterine bleeding, infertility and repeated miscarriage. Like the other diagnostic procedures, sonohysterography is done when the woman is not having her menstrual cycle.
Oviduct blockage treatment
The goal of treating oviduct blockages is to unblock fallopian tubes and increase the chances for a successful pregnancy. Surgical procedures are the primary treatment option to open blocked oviducts. If needed, doctors will use more than one procedure to treat oviduct blockage. Take a look at the various surgical and non-surgical options available today to treat this particular condition.
Laparoscopy: To treat oviduct blockages, laparoscopy is widely preferred. It involves inserting the scope into the abdomen and cutting away scar tissue which blocks the tubes and is a result of infection and/or endometriosis, primary causes for oviduct blockages. It helps in unblocking the oviducts and allows the eggs and sperm to meet and facilitates the egg to become fertilized.
Recanalization: A tiny wire is inserted into the tube to remove the blockage.
Salpingectomy: It involves removing a blocked fallopian tube or sealing it in order to maximize the functioning of the second, unblocked tube.
Tubal Reanastomosis: This is also a laparoscopic procedure in which small incisions are made through the abdomen. The blocked portion of the oviducts or fallopian tube is cut away and the healthy sections of the tube are connected. It is followed by a procedure called Salpingostomy to create a new opening in the tube close to the ovary.
Fimbrioplasty: This plastic surgery that facilitates to reshape ends of fallopian tubes closed off by scar tissue or some other blockage.
Tubal Cannulation: Is a non-surgical option which involves clearing blockages with the use of a catheter, or Cannula that is inserted through the uterus into the fallopian tube.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 9, 2020