Currently, obstruction of the fallopian tubes is one of the most common causes of female infertility. This process can be both organic and functional character. In the first case we are talking about the presence of anatomical changes of the fallopian tubes, which can be both congenital and acquired. In the second case, it should focus on the factors that act on the pipe periphery, and sometimes not even related to the reproductive system.
So, among the organic causes the formation of adhesions in the fallopian tubes are the following:
• the inflammatory process, mainly with chronic: sexually transmitted infections (chlamydia often leads to the development of adhesions in the tubes), infectious postabortive complications, salpingitis;
• unfavorable postoperative period, when there are adhesions after previous surgery on the pelvic organs: ovarian cyst removal, removal of fallopian tubes with ectopic pregnancy, removal of fibroids, appendectomy;
• congenital defects and anomalies of the pipe;
• previous curettage, which increases the risk of infection;
• traumatic injury of the uterus: insertion of an IUD, hysteroscopy, caesarean section or uterine rupture during labor.
For functional reasons, the development of tubal occlusion should be considered failures of different nature in the hormonal system, impaired psycho-emotional background (lots of stress). Considerable importance is given and this aspect as exercise from adhesions and massage the pelvic area.
Conservative treatment is not effective when it comes to adhesive process in the fallopian tubes. Conservative treatment can be effective only in the early stages of development of adhesive obstruction. Then assigned to anti-inflammatory drugs (antibiotics, NSAIDs and vitamins) and resolving physiotherapy (electrophoresis with absorbable drugs). Regarding the functional infertility, here it is recommended conservative therapy, which is based on the use of sedative drugs, multivitamin complexes and facilities, corrective normal hormonal background. Considerable importance is given and this aspect as exercise from adhesions and massage the pelvic area.
However, the most effective method of treatment is surgery, which is performed without incisions, using laparoscopic equipment. The operation is the dissection of adhesions in the pelvis and/or remove impassable section of the fallopian tube, followed by sewing the two remaining fragments together.
Much less commonly used incision in the form of a midline laparotomy. It is worth to remember that an ineffective first laparoscopy in most cases indicates that the next will also be ineffective.