How to treat heating pipe blockage

The most obvious manifestation of fallopian tube blockage is female infertility. Investigations have found that there is a relatively important relationship between female infertility and fallopian tube blockage. About 1/4 of female infertility is related to the fallopian tubes, and the main cause of fallopian tube damage is pelvic inflammatory disease. Therefore, when fallopian tube blockage occurs, it is important to understand the specific cause so that good treatment can be carried out.

How to treat heating pipe blockage

1. Treatment of proximal fallopian tube obstruction

Proximal tubal obstruction accounts for 10% to 25% of female fallopian tube diseases. The recanalization of proximal tubal obstruction can be achieved by hysteroscopic COOK guidewire recanalization or partial fallopian tube resection and re-anastomosis. Hysteroscopic guidewire recanalization is a procedure in which a COOK guidewire is inserted into the interstitial part of the fallopian tube under hysteroscopy to perform tubal fluid perfusion. The interstitial and isthmus parts of the fallopian tube are recanalized through the separation and dilation of the guidewire sheath and the impact of the liquid. The operation is simple, and about 85% of proximal fallopian tube blockages can be resolved by proximal guidewire dredging.

2. Treatment of mid-fallopian tube obstruction

Mid-fallopian tube lesions refer to obstruction or missing changes in the middle part of the fallopian tube. The causes of the disease are tubal pregnancy and tubal sterilization. Fallopian tube anastomosis is a commonly used surgical method for mid-fallopian tube obstruction. It is a procedure that removes the blocked part of the fallopian tube under laparoscopy and anastomoses the two ends of the fallopian tube. Foreign reports show that the postoperative pregnancy rate of fallopian tube anastomosis is 74% to 81%, and the incidence of ectopic pregnancy is 4.8%.

3. Treatment of distal fallopian tube obstruction

Distal fallopian tube lesions account for 85% of tubal infertility. The causes of distal fallopian tube obstruction are pelvic inflammatory disease and peritonitis and previous pelvic and abdominal surgery. (1) Salpingostomy is one of the commonly used methods to solve infertility caused by distal fallopian tube obstruction. However, since obstructed fallopian tubes are often accompanied by severe destruction of the ciliary tissue in the fallopian tube cavity and damage to the peristaltic ability of the fallopian tube muscle layer, the postoperative pregnancy rate is only about 30%. In addition to the operating skills, the factors that determine the success of the operation are also related to the degree of damage to the fallopian tube. In the case of external adhesions of the fallopian tube caused by endometriosis, appendicitis, etc., the ciliated cells and mucosal folds of the fallopian tube itself are not damaged, and the postoperative pregnancy rate is relatively high. On the contrary, fallopian tube obstruction caused by infection with chlamydia, gonococci or tuberculosis often causes serious damage to the fallopian tube endometrium, and the effect of salpingostomy is relatively poor. (2) This part of the fallopian tube fimbriaplasty refers to the disintegration or dilation of the narrowed fallopian tubes that have not yet completely closed and formed hydrops due to adhesions at the ends of the fallopian tube fimbria. Relatively speaking, the damage to the fallopian tubes in these patients is significantly milder than that in those with complete atresia or hydrops. Therefore, the effect of the surgery is more significant. If there is no obvious adhesion around the fallopian tube and ovary, and the fimbria mucosa is good after separation, more than 80% of patients can achieve intrauterine pregnancy after surgery. However, if the fallopian tube forms dense adhesions with the ovary or surrounding tissues and the wound is huge after separation, the prognosis of the operation will be poor, the natural conception rate after surgery will decrease, and the risk of ectopic pregnancy will increase. When both distal and proximal tubal obstruction exist, the surgical success rate is 5% or less.