Falloposcopy is a diagnostic method that allows visual inspection of the fallopian pipes from inside. Falloposcopy is performed to assess the abnormalities present in the fallopian tubes right from the uterotubal ostium to the fimbrial end. Hysterosalpingogram and laparoscopy are the conventional methods followed to assess the tubal function; however falloposcopy has been the preferred choice in recent times as it provides accurate visual status of the Fallopian tubes. Falloposcopy is highly useful in diagnosing the conditions such as scar tissue formation, adhesions, blockage in the tubes and damage in the inner lining of the tubes. Falloposcopy is not only used as diagnostic tool, but can also repair and help restore the health of the Fallopian tubes. Fallopian tube blockage is a common cause of female infertility and the procedure helps in recanalizing the obstruction.
The procedure involves inserting a thin catheter into the fallopian tubes. The Fallopian pipes are approached through the cervix and uterus. Once the catheter is placed, a tiny fiber optic endoscope is inserted through it. A small digital camera is attached at the end of the scope which allows the visualization of the fallopian tubes on the external monitor. Falloposcopy is generally carried out under local anesthesia or mild intravenous sedation. The ideal time to perform falloposcopy is mid-follicular phase of menstrual cycle as ostium can be evaluated better in the absence of blood and thick endometrial lining. Falloposcopy requires 30-45 minutes to perform. If followed by tubal reconstructive surgery, the time may extend up to 2 hours.
The catheter can be inserted by following two methods namely coaxial system or LEC (linear everting catheter). The coaxial system needs hysteroscope for its uterine passage and also makes use of the thin guide wire over which catheter is inserted. The guide wire is slowly withdrawn and falloposcopy along with camera will be introduced to take the inside images of the Fallopian tubes. LEC method is performed by unrolling the balloon catheter with internal endoscope and there by doing away with hysteroscopy. LEC method is the latest and preferred choice as inserting the falloposcope with LEC technique is easier and allows visual guidance throughout the process. Hence there is less chances of trauma.
There are no major known risks associated with the falloposcopy. However in rare cases, falloposcopy may cause tubal trauma and may also puncture the tubes. Like any other internal investigation, falloposcopy too carries the risk of infection and bleeding. The patient is normally advised to take antibiotics before the procedure to minimize the risk of infection.
Pelvic Inflammatory Disease
Nearly 1 million women in the US alone suffer from pelvic inflammatory disease or PID each year; PID is an infection in the reproductive organs of a woman. It is essential to treat the symptoms of Pelvic Inflammatory Disease immediately when noticed. Failure to do so may lead to complications such as infertility and even can be life threatening. Sexually transmitted diseases (STD) such as chlamydia or gonorrhea are often the cause for pelvic inflammatory disease. Women who have multiple sexual partners or partners with symptoms of chlamydia or gonorrhea infections are at a higher risk for PID. Some forms of contraception such as IUDs may put a woman at increased risk of PID. Surgical procedures such as D and C (Dilation and Curettage), insertion of IUD or treatment of an abnormal Pap smear can lead to pelvic inflammatory. Usually the cervix prevents the spread of bacteria into the internal organs. But when the cervix gets infected with an STD (Sexually Transmitted Disease), disease-causing bacteria travel up the internal organs and damage the uterus, fallopian tubes, ovaries and abdomen. Bacteria present in the vagina and cervix can also have a precipitating effect on the Pelvic Inflammation. Usually multiple organisms are responsible for a bout of PID. Spreading of the infection can lead to further inflammation and scarring.
Women suffering from PID experience high fever and chills. Dull pain in the lower abdomen and lower back are typical symptoms of pelvic inflammatory disease. A woman suffering from pelvic inflammatory disease may also experience fever and irregular menstrual bleeding. Other symptoms of Pelvic Inflammatory Disease are pain during intercourse and urination. Some women do not experience any symptoms at all. Laboratory tests for chlamydia, gonorrhea and urinary tract infection are conducted on a patient who might be suffering from PID. A pelvic ultrasound helps in looking for any abnormalities in the pelvic area or fallopian tubes. Pelvic Inflammatory Disease can also be diagnosed with falloposcopy - a visual study of the inside of the fallopian tubes.
Treatment for pelvic inflammatory disease is based on pelvic examination and examination of the woman's sexual and menstrual history. Antibiotic therapy of Floxin is used as oral medication for PID. This is the first FDA approved oral therapy for PID. Other drugs used in combination for treatment of Pelvic Inflammatory Disease are Cefoxitin, Oflaxocin, Clindamycin. If left untreated, pelvic inflammatory disease can lead to severe and permanent damage of the reproductive organs.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 9, 2020