Analysis for patency of the fallopian tubes as done. How to check the patency of the fallopian tubes - symptoms and diagnostic methods

HSG (hysterosalpingography) of the fallopian tubes is one of the types of gynecological diagnostic examination. The technique gives the doctor reliable data on the state of the reproductive organs.

According to the method of conducting the study is divided into X-ray and ultrasound. Modern ultrasound HSG is considered a more effective and safer procedure for women's health than the standard x-ray type of study.

What is HSG in gynecology?

The procedure is an x-ray of the uterus and fallopian tubes. The purpose of the study was to determine their patency and diagnose the physiological state of the uterus in women. In most cases, the procedure is prescribed for an established diagnosis of infertility and habitual miscarriage.

Ultrasound hysterosalpingography

Modern medical equipment allows you to conduct a study without the use of X-ray irradiation. Ultrasound hydrosonography is performed using sterile saline, which is injected into the uterine cavity using a soft catheter for hysterosalpingography.

Saline enters the uterine cavity and fills the fallopian tubes. The doctor evaluates this process and controls it using a transvaginal ultrasound probe. Ultrasound helps to determine if the liquid flows freely in the pipes. In the presence of obstacles and impaired patency, the liquid will not spread correctly.

Advantages of ultrasonic HSG:

painlessness and physiology;
no harmful effects of x-ray exposure on ovarian follicles;
lasts about half an hour, which allows you to best assess the condition of the fallopian tubes;
does not cause individual reactions and allergies.

Indications and contraindications for diagnostics

Indications for the procedure are the following pathologies:

suspicion of infertility;
endometriosis and endometrial hyperplasia;
physiological malformations of the vagina, cervix, uterus itself and appendages;
isthmicocervical insufficiency.

Contraindications:

the presence of an acute infectious process;
heart failure;
thrombophlebitis;
renal and liver failure;
hyperthyroidism, impaired thyroid function;
inflammatory process in the uterus and appendages;
acute inflammation of the vagina and vulva (colpitis, vulvovaginitis);
unfavorable blood test (increased leukocytosis, increased erythrocyte sedimentation rate);
adverse urinalysis;
individual intolerance to iodine;

An absolute contraindication is the period of pregnancy and lactation.

On what day of the cycle is hysterosapingography performed?

The exact length of time for the procedure depends on the purpose of the study. To confirm the diagnosis of endometriosis, the procedure is prescribed on the 7-8th day of the cycle. To determine the degree of patency of the fallopian tubes, an examination is prescribed for the second phase of the cycle. HSG can be performed at any phase of the cycle to detect the presence of uterine fibroids.

The most optimal time for the study is the first two weeks after menstruation. During this period, the endometrium is still thin enough to provide free access to the mouth of the fallopian tubes.

Preparation for HSG of the fallopian tubes

The HSG method is safe and less traumatic, but it is an invasive procedure and therefore requires special training. Preparation for hysterosalpingography includes the following steps:

it is necessary to undergo a general gynecological examination and take tests for hysterosalpingography: a bacteriological smear from the vaginal mucosa is necessary to make sure there are no genital infections;
to diagnose other infectious diseases, it is necessary to take blood tests;
during the week before the examination, do not use vaginal suppositories and suppositories, sprays, douching solutions and intimate hygiene products;
within two days before the study, you should refrain from sexual contact;
sometimes the doctor prescribes allergy tests for a contrast agent used in the x-ray form of the study;
if the procedure is carried out in the second phase of the cycle, a pregnancy test is performed.

Diagnostic technique

Before the procedure, a woman must undergo a routine gynecological examination with mirrors.

The procedure does not take too long. After examination, a special tube (soft catheter) is inserted into the cervix. Through this tube, the doctor with a syringe injects a contrast agent for X-ray examination into the uterine cavity. After some time, when the contrast fluid penetrates the tubes, the doctor takes x-rays showing the condition of the fallopian tubes.

The liquid for research is absolutely safe for health. It is excreted from the patient's body without a trace, being absorbed into the bloodstream, without requiring any additional procedures to clean the uterus.

Is it painful to do a tubal HSG procedure?

Many women are interested in whether the study will be painful. The procedure is considered a painless, minimally invasive diagnostic method, therefore anesthesia or local anesthesia is not required before the procedure. In some cases, local anesthesia with lidocaine is used if the patient does not have an individual intolerance to the anesthetic.

During the procedure, there may be discomfort, reminiscent of menstrual pain in the lower abdomen. An hour after the end of the examination, they disappear.

Video: "How is hysterosalpingography done and what are the advantages of diagnosis?"

Procedure results

X-rays show how the contrast agent passes through the fallopian tubes. If the fluid has filled the tubes and entered the abdominal cavity, the doctor checks for patency of the fallopian tubes. In the event that the liquid has not completely penetrated the pipes and stopped at a certain level, the specialist confirms the presence of obstruction and prescribes further treatment.

If the study was carried out correctly, it is quite informative and allows not only to confirm or refute the presence of obstruction, but also to identify various intrauterine pathologies.

Consequences and complications of HSG of the fallopian tubes

Complications and consequences after the procedure are rare. One of the types of possible complications is an individual allergic reaction to the contrast fluid used for the procedure. If the examination technology is violated, inflammation of the appendages may begin.

As for X-ray exposure, its doses during examination are so small that they do not cause any harm to women's health.

Some experts note that pregnancy after tubal HSG is easier, and the procedure increases female fertility, contributing to the rapid conception of a child.

Recovery after HSG

Within a couple of days after the procedure, the patient may experience minor bleeding from the vagina. Discharge is associated with trauma to the cervix and is most commonly seen in women suffering from cervical erosion.

Minor pains in the lower abdomen pass quickly enough, without requiring additional anesthesia.

Estimated cost of hysterosalpingography

It is best to find out how much the HSG of the fallopian tubes costs directly at the medical institution where hysterosalpingography is done. On average, the cost of the procedure varies between 4000-8000 rubles (150-250 dollars), depending on the clinic.

Today, X-ray HSG of the fallopian tubes is considered an outdated technique, which is increasingly being replaced by high-tech ultrasound and computer. In combination with other diagnostic methods, the procedure allows you to quickly and effectively diagnose and determine the physiological state of the woman's reproductive organs.

The fallopian tubes connect the ovary to the uterus, and the mature egg, moving from the ovary, is fertilized by the sperm in the tube. The tube then pushes the egg into the uterus. Obstruction of the fallopian tubes is one of the causes of female infertility.

Obstruction may be due to:

operations on the pelvic organs (including removal of appendicitis);
transferred inflammation (most often - chlamydia).

Obstruction can occur not only in the tube itself, but also between the ovary and the tube as an adhesion (adhesion of the walls of the fallopian tubes and ovaries).

Fallopian tube adhesion

Is it necessary to remove the fallopian tubes in case of their obstruction?

Conservative treatment (no surgery) used in cases where obstruction is caused by inflammatory processes. At the same time, anti-inflammatory drugs, physiotherapy are prescribed, but in the case of the formation of adhesions, such treatment is ineffective.
Surgical treatment- surgical intervention. Usually, surgical treatment is carried out by laparoscopy - it practically does not give complications. But no one can give a 100% chance of curing infertility associated with impaired patency of the fallopian tubes. Removal of the fallopian tubes is an extreme measure, and is used in exceptional cases.

How to check the patency of the fallopian tubes?

Checking the patency of the fallopian tubes can be carried out in several ways:

diagnostic laparoscopy (checking the patency of the fallopian tubes is carried out, as a rule, during the operation to remove adhesions - laparoscopy is usually not prescribed just to check the tubes);
HSG (hysterosalpingography, MSG, metrosalpingography - other names);
hydrosonography (ultrasound);
fertiloscopy (a method similar to laparoscopy; often combined with it). The difference between fertiloscopy and laparoscopy is that the instruments are inserted not through the abdominal wall, but through the vagina.

How to check the patency of the fallopian tubes, which method to choose?

Taking into account the fact that both laparoscopy and fertiloscopy are traumatic methods, and ultrasound does not give a clear “picture of what is happening”, HSG is the optimal method in most cases.

HSG, or hysterosalpingography

Hysterosalpingography (HSG) - X-ray examination of the fallopian tubes for patency. Hysterosalpingography is an important stage in the examination of a woman diagnosed with infertility. The accuracy of the study is at least 80%.

Hysterosalpingography allows you to diagnose:

patency of the fallopian tubes;
the state of the uterine cavity and the presence of endometrial pathology - an endometrial polyp;
the presence of deformities in the development of internal organs and the uterus, for example, a saddle uterus, an intrauterine septum, a bicornuate uterus, etc.

How is tubal patency checked with HSG?

A contrast agent is injected into the cervix - a blue solution. It fills the uterine cavity and enters the tubes, from which it flows into the abdominal cavity. In this case, an x-ray is taken, which shows the state of the uterine cavity and fallopian tubes.

In most cases, the procedure helps not only to assess the patency of the fallopian tubes, but also makes it possible to see the presence of tube deformation:

extension;
tortuosity;
braces, etc.

Hysterosalpingography can be performed only in the absence of inflammation. Before the start of the examination, they are tested for HIV, hepatitis B and C, syphilis, as well as a general smear for the flora. HSG does not require general anesthesia.

As a rule, in women who are trying to become pregnant, hysterosalpingography is performed on the 5th-9th day of the menstrual cycle, if its duration is 28 days. If a woman is protected from pregnancy, the examination is possible on any day of the cycle, except for menstruation.

Disadvantages of hysterosalpingography

The procedure is rather unpleasant.
The pelvic organs are irradiated.
After HSG during one menstrual cycle it is necessary to be protected.

Hysterosalpingography

Ultrasound of the patency of the fallopian tubes

Testing for patency of the fallopian tubes Ultrasound (hydrosonography) is an alternative to hysterosalpingography. Ultrasound has several advantages over HSG:

less unpleasant procedure;
unlike HSG, no radiation is used, which can have a negative impact on a woman's reproductive health;
while careful protection is required after HSG, tubal ultrasonography is safe.

The main drawback of the procedure is the lower accuracy of the results compared to the HSG.

When is the patency of the ultrasound tubes checked?

An ultrasound tube test is usually performed on the eve of ovulation: at this time, the likelihood of spasm is reduced and the cervical canal is dilated. Unlike hysterosalpingography, in this case it is not very important on which day of the cycle the tubes are checked for patency using an ultrasound scanner. Before checking the patency of the fallopian tubes, it is necessary to take tests to exclude the presence of inflammatory diseases.

How is the patency of the fallopian tubes checked by ultrasound?

Determining by ultrasound the patency of the fallopian tubes is almost painless. A special catheter is inserted through the cervix into the uterine cavity, warm saline is slowly poured into it under ultrasound control. If it flows into the fallopian tubes, then the tubes are passable. If not, their obstruction is likely.

Disadvantages of checking the patency of the fallopian tubes by ultrasound:

relatively large amounts of fluid, as well as spasms of the uterus and fallopian tubes, discomfort can be caused;
if the ultrasound showed that saline does not pass, this may not always mean obstruction of the tubes. The reason for this may be a strong spasm.

Laparoscopy. How to check the patency of the fallopian tubes with its help?

Laparoscopy is a surgical method for assessing the patency of the fallopian tubes. Through punctures in the abdominal wall with the help of optical instruments, an examination of the internal organs is carried out. If you are scheduled for laparoscopy, the forum can help you choose a clinic or even a surgeon.

Laparoscopy in gynecology is a method for the treatment and diagnosis of various pathologies of the pelvic organs. Operation laparoscopy is one of the modern methods of surgery with minimal intervention and damage to the skin. Laparoscopies are performed for both diagnostic and therapeutic purposes.

Laparoscopy can be performed to clarify various diagnoses. If you feel pain after laparoscopy, contact the clinic where you had the operation.

Diagnostic laparoscopy is an operative research technology in which the doctor examines the abdominal organs without making large incisions on the abdominal wall. Most often, two small incisions are made. A small amount of gas is injected into the abdominal cavity to increase the field of view.

A device called a laparoscope is inserted into one incision - a thin tube at one end with a lens, and at the other with an eyepiece (the second end can also be connected to a video camera unit that transmits an image to the screen). A manipulator is inserted into another incision, with the help of which the doctor displaces the abdominal organs, carefully examines them and makes a diagnosis.

Diagnostic laparoscopy is performed to assess the condition of the outer surface of the fallopian tubes and pelvic organs, as well as to identify their pathologies.

The most common operations:

laparoscopy of the ovaries;
laparoscopy of the fallopian tubes;
laparoscopy of the abdominal organs.

After laparoscopy:

The patient stays at the hospital, as a rule, for no more than a day: doctors monitor her condition, perform an ultrasound scan. After 2-3 days you can return to work.
It is not recommended to drink alcohol and heavy food in the next 2-3 weeks after the operation. - Sex should be postponed for 2-3 weeks to avoid infection.
Physical activity should be increased evenly. It is better to start with walking and gradually increase their duration. Heavy after the operation should not be lifted.

Laparoscopy of the ovaries

This procedure is performed not only to remove cysts. At the same time, this is the most effective method of treating ovarian cysts of a different nature. It can also be an effective treatment for endometriosis, a disease in which cells from the inner layer of the uterine wall grow outside of this layer. In this case, an endometrioid cyst may form.

Laparoscopy of the ovaries allows you to remove the cyst and adhesions, return the woman the opportunity to have children. Literally a couple of days after the laparoscopy of the ovarian cyst was performed, he returns to his normal boundaries and fully restores his functions.

Pain after laparoscopy is very rare, the stitches usually heal quickly without causing discomfort - painkillers are taken in extreme cases, as directed by a doctor.

Laparoscopy of an ovarian cyst is not an easy operation. Choose a good doctor, because often the appearance of cysts in the future, as well as the possibility of pregnancy, depends on the accuracy of the operation.

Laparoscopy of the uterus

Laparoscopy of the uterus is an effective way to treat fibroids. The operation is also prescribed for the treatment of various malformations of the uterus.

Laparoscopy of uterine fibroids

The determining factors in choosing a method for treating uterine fibroids are the intention to have children in the future, the size of the uterus, the size of the myoma nodes, and their location. Laparoscopy is a good option for removing small fibroids.

Laparoscopy of uterine fibroids is not performed in such cases:

the size of the uterus is larger than the fetus at the 11-12th week of pregnancy;
multiple myomatous nodes developed;
the size of the nodes is large;
myoma nodes are located low.

In these cases, it is better to use other methods of removal, such as laparotomy.

Treatment of fallopian tubes with laparoscopy

Tubal laparoscopy is a method in which anesthesia is used, and the occurrence of spasm is excluded. Therefore, checking the tubes using laparoscopy gives very accurate results. Laparoscopy of the fallopian tubes allows you to remove adhesions. The operation of laparoscopy is prescribed if treatment of the fallopian tubes and their pathologies is necessary.

Laparoscopy of the tubes may be prescribed in the following cases:

formation of adhesions of the fallopian tubes;
ectopic pregnancy;
obstruction of the fallopian tubes;
diagnosis of female infertility;
endometriosis;

Period after laparoscopy

If menstruation is painful, then the first menstruation after laparoscopy usually passes with more blood loss than usual and longer duration. This is because internal organs take longer to heal than incisions in the abdominal wall. In this regard, the first menstruation is usually more painful. But still, with a strong menstrual pain should consult a doctor.

Pregnancy after laparoscopy

After laparoscopy is done, you can become pregnant within a few months, but immediately after the operation for 2-3 weeks, you must completely abandon sexual intercourse. After that, you can plan conception. Pregnancy after laparoscopy is quite possible in the near future.

Women who have become pregnant after laparoscopy within a few months are observed by a gynecologist. Often pregnancy is accompanied by drug treatment, a woman takes drugs to support the normal hormonal background of pregnancy. If pregnancy does not occur after laparoscopy, this operation can be repeated several times.

Laparoscopy - reviews

If you are scheduled for laparoscopy, the forum is not the best source of information. It can come in handy in one case: if you want to choose a clinic or a doctor: patients who have had laparoscopy leave reviews very willingly.

Is it worth restoring the patency of the pipes?

You can get pregnant within about a year after the restoration of the patency of the tubes - the likelihood that they will soon become impassable again is very high. In addition, the tube should not just be passable: it should move the fertilized egg to the uterus. If she does not do this, an ectopic pregnancy is formed.

Any operation to restore tubal patency increases the risk of ectopic pregnancy. Thus, the restoration of patency is far from a guarantee that you will be able to get pregnant. In addition, any operation can start the process of adhesion formation.

If you are young and there are no more factors that prevent you from getting pregnant, it makes sense to operate the tubes. If you are over 35 and have been trying to have a baby for a long time, consider artificial insemination. With each ovulation, the "quality" of the eggs deteriorates, and you should not waste months on the restoration of the tubes - time is against you. Based on everything that we have described above, consult with your doctor to find out if you should even deal with the restoration of tubal patency.

The ability to conceive, bear and give birth to a healthy child is the main feature, value and joy in a woman's life. It is no coincidence that in ancient times even the very meaning of a woman's life was evaluated by her ability to bear children. We live in much more enlightened and freedom-loving times, when women can afford to plan a family, the number of children and the time of their birth at their discretion. But as before, motherhood remains the most important and happiest period of life, without which it is difficult to fully experience all its facets. An important condition for the implementation of this function is the health of the organism as a whole and the reproductive system in particular. A particularly important role is played by the fallopian tubes and their ability to pass an egg through itself, ready for fertilization.

Violations of this function, that is, the patency of the fallopian tubes, are fraught not only with diseases of the female genital organs, but also with a complete loss of the ability to have children. That is why it is so important to diagnose developing deviations in time and take all possible measures to prevent the problem from worsening. Moreover, obstruction of the fallopian tubes, complete or partial, is far from a sentence and not a guarantee of infertility. With timely and high-quality treatment, you can get rid of it and give birth to a healthy child, not even one. That is why modern medicine has developed and actively uses methods for checking the patency of the fallopian tubes. Effective and safe, they allow you to identify deviations at an early stage and prevent possible complications. But for this you need to know about these methods and understand their importance, and also not to neglect regular examinations by a specialist.

Fallopian tubes: structure, functions, health
The fallopian tubes in science and medicine are called fallopian tubes or, more simply, oviducts. The second name in itself quite clearly describes their role in the female body. Indeed, the fallopian tubes are a paired organ that connects the ovaries with the uterine cavity and creates a kind of "corridor" through which the egg enters the uterus. In the fallopian tubes, fertilization occurs when the ovulated egg is captured by the cilia of the epithelium and moves into the fallopian tube, where it can stay from 8 to 24 hours. All this time, she remains viable thanks to a special environment inside the oviduct and is waiting for a meeting with a sperm cell. If that meeting occurs and the egg is fertilized, then the cilia on the surface of the tubal epithelium propel it further into the uterus. If the egg remains unfertilized, then through the same oviducts it still goes to the uterus, where it gradually dies.

Thus, it is from these small tubes located on both sides of the uterus that it directly depends on whether the female and male germ cells will unite, whether conception will occur, whether the zygote (fertilized egg) will enter the uterine cavity. This is the role of the fallopian tubes in the implementation of the function of childbearing, and it is provided by their specific structure. The walls of the oviducts are similar in composition to the walls of the uterus and, like her, have several layers of mucous and epithelial tissue. This fabric forms tubes from 8 to 20 cm long (about 12 cm on average). The main difference between the fallopian tube mucosa and the uterine mucosa is the presence of mobile cilia designed to transport elements that enter the tubes: eggs, spermatozoa and zygotes. At the same time, each of the two pipes is quite mobile and flexible. Healthy, developed oviducts consist of:

A funnel located on the side of the abdominal cavity, that is, the ovaries, and having a diameter of about 20 cm. With the help of many fringes, the funnel covers the ovary and ensures that the egg enters the tube, and then moves along it.
Ampullary area, narrower than the infundibulum, but still wide enough for the egg to pass through.
Isthmic area, which narrows as it approaches the uterus. This narrowed part of the oviduct forms a kind of isthmus.
The uterine area - that is, the place where the fallopian tube passes directly into the uterine cavity.

This structure corresponds to the ideal state of a healthy female body. But any deviations in the structure or functioning of the listed elements threaten to disrupt its reproductive ability. Dysfunction and / or obstruction of the fallopian tubes may be associated with their infection or failure, inflammatory processes and damage are fraught with the formation of scars and scars that glue and block the narrow passage to the eggs. And the causes for such inflammations are most often bacterial infections and sexually transmitted diseases. Timely detected and not cured, they proceed as they will and lead to serious damage to the oviducts and their individual sections, which threatens infertility.

Even medical manipulations performed without direct contact with the uterus and / or oviducts can cause damage and obstruction of the fallopian tubes. For example, previous operations on other pelvic organs - even a common appendectomy - can lead to obstruction. The “soldered” place of the tube can be located both along its length and between the tube and the ovary. Such places are called - soldering - and are, in fact, stuck together walls of the oviduct and the ovary itself. Treatment in this case can be both medical and surgical. Of course, no doctor can give a 100% guarantee of a complete cure. But the removal of the fallopian tubes in the event of the formation of adhesions is an extreme measure, which is extremely rare. In most cases, conservative and surgical treatment in combination lead to a favorable resolution of the problem.

Checking the patency of the fallopian tubes
Today, medicine has a whole range of methods for diagnosing the condition of the fallopian tubes.

HSG, or hysterosalpingography. The same method can be found under the names MSG, metrosalpingography - know that under these complex names one and the same method of checking the patency of the fallopian tubes is hidden. It consists in radiography and allows you to see not only the lumen of the oviducts, but also possible deformations of the uterus and other internal organs, to assess the condition of the endometrium and the uterine cavity. With the help of HSG, it is possible to diagnose such diseases as a polyp of the uterine endometrium, a bicornuate uterus, a saddle uterus, a uterine septum, and some others. But most importantly, hysterosalpingography demonstrates any expansion, constriction, tortuosity of the fallopian tubes that prevent their patency. At the same time, the results of the study provide information with an accuracy of at least 80%.
The HSG includes two successive stages. First, a fluid of contrasting color is injected into the uterine cavity. Most often, a blue solution is used for these purposes. It is quite safe and, filling the internal spaces of the genital organs, that is, the uterine cavity, the fallopian tubes themselves and even the abdominal cavity, clearly shows their appearance in the picture taken by the x-ray machine. The main drawback of the HSG is the need for careful preliminary preparation for this procedure. In particular, the HSG is carried out only on certain days of the menstrual cycle: for example, if it is a standard 28 days, then the procedure can be planned only from the 5th to the 9th day of the cycle. True, if the patient uses contraceptive methods, then hysterosalpingography is allowed at any time except for the days of menstrual bleeding.
In addition, the presence of any inflammatory processes of the pelvic organs is an absolute contraindication to hysterosalpingography. And beforehand, the patient is obliged to undergo an examination and make sure that she is not sick with syphilis, HIV, hepatitis B, hepatitis C, pass a smear to check the internal flora. Anesthesia during the procedure is not accepted, so the HSG itself is a physically rather unpleasant process. After the HSG was carried out during one menstrual cycle, it is necessary to protect yourself from pregnancy even if the purpose of the diagnosis is to get rid of infertility. But in general, hysterosalpingography is currently considered the best of the existing methods for checking the patency of the fallopian tubes.
Hydrosonography (ultrasound)- a method that is alternative to hysterosalpingography, and has some advantages over it. In particular, during hydrosonography there is no need to use x-rays, the radiation of which in itself can adversely affect the state of the internal organs of a vulnerable female body. In addition, the hydrosonography procedure does not cause such unpleasant sensations as the HSG and does not require mandatory protection from pregnancy. True, for its implementation, you also need to choose the right time: ultrasound of the fallopian tubes is best done on the eve of ovulation, when the cervical canal is relaxed and dilated, and the likelihood of spasm, respectively, is the lowest. But it is still necessary to take tests to check for the presence of internal inflammatory processes.
Although the procedure of hydrosonography is almost painless, it is associated with a certain intervention inside the body. A special thin catheter is inserted through the cervix in order to pour saline at a comfortable temperature through it. Then everything is simple: with the help of an ultrasound machine, the movement of the liquid is monitored. If it freely penetrates inside, it means that the fallopian tubes normally pass it, that is, the patency is not impaired. Otherwise, we are talking about a violation of the patency of the fallopian tubes. True, sometimes the cause of the failure of the passage of saline can be uterine spasm, and the diagnosis will turn out to be erroneous. This is the main drawback of hydrosonography - its accuracy is noticeably lower than that of HSG. Yes, and the liquid for its implementation is used relatively more. But still, ultrasound of the fallopian tubes is still widely used today in cases where HSG is not recommended for one reason or another.
Diagnostic laparoscopy- a rather traumatic method, often associated with an operation to remove adhesions, and usually it is not prescribed on its own just to check the patency of the fallopian tubes. But in general, laparoscopy can be prescribed for both diagnostic and therapeutic purposes. To date, this method is considered the most gentle of the possible surgical methods, because it is accompanied by minimal skin damage and intervention. However, laparoscopy is, in fact, a puncture of the abdominal wall so that with the help of a surgical apparatus it is possible to examine the internal organs and assess their condition. As a rule, two incisions are made in the skin, but they are relatively small in size. In addition, a special gas is injected into the abdominal cavity, which expands the internal space and facilitates examination.
The device for laparoscopy consists of two thin tubes: the first, with a lens at one end and a video camera lens at the other end, is inserted into one cavity incision. The second tube is a manipulator with which the doctor can move the internal organs in the abdominal cavity through the second incision and how they should be examined. Based on the results of this examination, a diagnosis is made. It reports information about the state of the outer surface of the pelvic organs and directly the fallopian tubes, reveals possible pathologies depending on the specific purpose of laparoscopy (laparoscopy of the fallopian tubes, ovaries or other organs). After that, for recovery after surgery, the patient is left under supervision in the hospital of the clinic for about a day. After a couple of days, she will be able to go to work and continue her normal daily life, but she will have to forget about sex, drinking alcoholic beverages and hard to digest food for another month.
Rehabilitation after laparoscopy is a long and gradual process. The patient should not lift heavy things, and physical activity can be introduced very gradually, starting with slow walks in the fresh air. As a rule, the first menstruation after laparoscopy is especially painful and abundant, and pregnancy is possible soon enough, but it is not advisable to plan it earlier than a few months after the procedure. This is due to the long period of healing of internal organs. But the accuracy of laparoscopy is very high, the procedure is performed under anesthesia and therefore eliminates uterine spasm. In addition to determining the presence of pathological abnormalities, laparoscopy allows you to remove adhesions of the fallopian tubes and thereby restore their patency. After that, within a year, the onset of pregnancy is likely.
Fertiloscopy. This method is very similar to laparoscopy in essence, but differs from it in the introduction of a surgical apparatus: for the introduction of instruments, not a puncture in the abdominal wall is used, but the vagina. Fertiloscopy also refers to surgical and traumatic techniques and is often combined with laparoscopy. But on the other hand, for carrying out fertiloscopy, abdominal incisions and, accordingly, general anesthesia are not needed. With this method, the introduction of local anesthesia is sufficient. After the procedure, there are no scars on the skin, and the rehabilitation process lasts less. As a rule, the patient stays in the hospital for no longer than 3-5 hours after fertiloscopy. The whole procedure takes from 15 minutes to half an hour, and as a result, the doctor gets a reliable picture of the condition of the fallopian tubes, their patency, the presence of adhesions, possible pathologies of the uterine cavity and endometrium, and even the ability to perform minor operations.
Fertiloscopy is a chance to avoid the relatively more traumatic laparoscopy, but it is strictly contraindicated in women with endometriosis and uterine fibroids. Fertiloscopy helps to restore ovulation and the patency of the oviducts. At the same time, both the procedure itself and the equipment for its implementation today remain quite expensive and therefore are used only in some clinics. The implementation of fertiloscopy requires doctors of the highest professional qualifications and literally jewelry precision. Therefore, if it is possible to diagnose first with other, sparing methods (ultrasound or HSG), then it is better to start with them. And only if these methods did not show any pathologies, the second spouse is definitely healthy, but pregnancy does not occur, it makes sense to turn to fertiloscopy.
Pertubation / kymopertubation are carried out less frequently compared to the methods listed above, but also take their place in the list of ways to check the patency of the fallopian tubes. For their implementation, a gas is introduced directly into the uterine cavity using the thinnest flexible catheter: air or oxygen. At the same time, the fallopian tubes naturally contract, and this process is fixed by special equipment, which, in turn, reflects its course in the form of a curve pattern. This procedure is almost painless and for its implementation it is enough for the patient to inject no-shpa or baralgin. Kymopertubation is performed simply on a gynecological chair and usually takes no more than 5 minutes, plus the insignificant time that a computer needs to calculate and build a schedule.
Kymopertubation shows the condition of the fallopian tubes, their patency or impaired patency and / or peristalsis of the oviducts. In each individual case, it is possible to combine this method with other diagnostic methods: for example, performing hypopertubation after hysterosalpingography or before laparoscopy. At the same time, it is necessary to plan hypopertubation before ovulation, that is, in the first phase of the menstrual cycle, and to exclude the possibility of inflammatory processes in the pelvic organs. Vaginal smears are preliminarily taken for flora. Cymopertubation allows you to get rid of doubts and start planning a pregnancy with a favorable diagnosis or gives recommendations for additional examination and / or treatment in case of abnormalities.

Thus, you can check the patency of the fallopian tubes in one or several different ways, each of which has its pros and cons, indications and warnings. In any case, the study is necessary for women who cannot become pregnant for the first time, who have had an ectopic pregnancy, pelvic inflammatory disease and / or suffering from endocrine diseases. And even if the results of the test are disappointing and show obstruction of the fallopian tubes, there are also several medical and surgical methods for restoring patency. And in vitro fertilization always remains an emergency exit. So, the main thing is not to despair, to undergo diagnostics in a timely manner, take care of your health and strive to become a healthy and happy mother of a beautiful baby.

Children are an extension of ourselves, so almost every woman dreams of a happy and healthy offspring. However, some are faced with the inability to conceive after hearing the terrible diagnosis of "infertility". To find out the reasons, to decide on the methods of treatment, the gynecologist will refer you to check the fallopian tubes. This is one of the first procedures on which the reproductive functions of the body depend. How is the patency of the fallopian tubes checked, how painful is the procedure? Let's look into these issues.

Why is the patency of the fallopian tubes disturbed

The uterus is the most important organ, the health of which determines the possibility of conceiving and bearing a child. The fallopian tubes (popularly known as the oviducts) are a paired organ that connects the abdominal cavity to the uterus. They are located horizontally on both sides of the uterus, have a cylindrical shape with a diameter of 4 to 6 mm. The inner surface of the fallopian tubes is covered with epithelium with cilia, which help the egg to move.

The fallopian tubes differ slightly in length from each other, which ranges from 10 to 12 cm. An egg and a sperm cell meet in them. The more “correctly” the cilia of the epithelium inside the fallopian tubes function, the more likely a woman is to become pregnant. A fertilized egg moves along them and enters the uterus for further development.

According to doctors dealing with infertility problems, from 30% to 40% of all cases of a disappointing diagnosis are associated with obstruction of the fallopian tubes. The causes of the disease can be:

Organic:
- the presence of inflammatory processes of a nonspecific nature, which are caused by the ingress and active reproduction of bacteria;
- sexually transmitted infections - gonorrhea, chlamydia, ureaplasma, mycoplasma infections, trichomoniasis, genital herpes;
- gynecological operations and complications after them;
- abortions;
- surgical interventions in the treatment of diseases of the abdominal cavity (appendicitis, peritonitis), diseased pelvic organs;
- diseases of the reproductive system - salpingitis, saktosalpinks, endometriosis, uterine fibroids.
Functional. These reasons are caused by deviations in the structure of the fallopian tubes, congenital complete or partial absence of the latter. In rare cases, they occur due to severe stress or hormonal disorders.

To identify or refute the diagnosis of "infertility", to understand the causes of the disease, to prescribe an adequate, effective treatment, it is necessary to consult a specialist, conduct clinical trials. Many women find out about the presence of inflammatory processes, cysts, fibroids by chance during the diagnostic process. Do not forget about the need to undergo gynecological examinations at least once every six months.

Effective methods for determining the patency of the fallopian tubes

How is the patency of the fallopian tubes checked? Methods proven over the years are painful, require lengthy clinical studies, and are performed under general anesthesia. Newer, modern methods of diagnosis are relatively painless, do not require general anesthesia. To choose the most suitable method:

Consult a gynecologist for advice.
The doctor should take a gynecological history.
Depending on the results, diagnostics / treatment or surgery is prescribed to restore the patency of the fallopian tubes.

HSG (Hysterosalpingography)

This procedure consists in conducting an examination of the patency of the fallopian tubes using an x-ray. Hysterosalpingography helps determine if the fallopian tubes are patent; the presence of deformation changes in the uterus, appendages; learn about the state of the endometrium, the presence of pathologies. The essence of the diagnosis is the introduction of a special substance into the cervix through the cervical canal, visible on x-ray photos.

The specialist sees in the picture the condition of the uterus and appendages: the presence of extensions, constrictions, adhesions, tumors. On average, about 13 mg of fluid is injected. If the fallopian tubes have patency, then the fluid flows out of the uterus, around the ovaries. The procedure is performed 7-12 days after ovulation. It is important that there are no inflammatory processes. The reliability of the method is 80% or more.

Ultrasound (Hydrosonography)

It is possible to check the patency of the fallopian tubes with a reliability of at least 90% without a high dose of radiation using ultrasound in 2D, 3D or 4D measurement. This method is called hydrosonography or echosalpingography (echohydrotubation). For visual confirmation / refutation of the diagnosis, a special vaginal probe is inserted into the uterine cavity. The main disadvantage of the procedure is the high dependence of the results on the qualifications of the operator servicing the apparatus, his ability to correctly and competently decipher the images.

This expensive operation requires a hospital stay of one to two days. It is a surgical procedure in which a laparoscope is inserted through a small incision in the abdominal cavity into the fallopian tubes. The accuracy of diagnosis is 99.9%. The procedure is used to diagnose the patency of the oviducts, possible complications (cysts, tumors) after infectious, inflammatory processes, treatment of the pelvic organs (uterus, ovaries, appendages).

Fertiloscopy

The difference between fertiloscopy and laparoscopy lies in the introduction of the endoscope through the cervical canal. This relatively new method helps to accurately control the condition of the uterus and its appendages. The less likely it is to detect obstruction of the fallopian tubes, the more preferable is fertiloscopy. Unlike HSG, this method gives more accurate results for uterine spasms, which negatively affect the reliability of hysterosalpingography.

What tests should be done before the examination

Before being sent to check the patency of the fallopian tubes, the gynecologist will offer you to take tests:

Urogenital discharge (gynecological smear).
Cytological examination of scrapings of the cervix and cervical canal using the PAP test.
For sexually transmitted infections, HIV, TORCH infections by polymer chain reaction (PCR).

Where to do and how much does a study cost in Moscow

Public, private clinics and hospitals offer a wide range of services for women who need to check the patency of the fallopian tubes. If a few decades ago, such a diagnosis put an end to a woman’s desire to become a mother, then modern achievements of scientists help restore the functionality of the fallopian tubes, giving joy, the happiness of motherhood.

The price of services differs depending on the type of diagnosis, the degree of reliability of the final results, possible consequences and side effects:

Clinic name	Type of analysis
Clinic InVitro	Taking gynecological material
	Comprehensive analysis "Sex and the City": 12 infections + smear
	Cytological examination of scrapings of the cervix and cervical canal PAP test
Polyclinic "Otradnoe"	Cytology
		180 to 2780
Women's Health Center	Comprehensive tests for the detection of latent infections + PAPP test
	Study of infections by PCR from 1 to 18 infections	From 350 to 2950
	smear on flora
	Taking a biomaterial (smear)
	Comprehensive service (tests to detect tubal patency)	From 5500 to 15000
OnMed Gynecology	Taking a biomaterial (smear)
	Study of infections by PCR from 1 to 20 infections	From 300 rub.
	Cytology

Types of diagnostics and prices for them in various clinics:

Type of clinical/diagnostic study	Approximate cost, rub.	Clinic name
		He Clinic (international medical center)
Description of the picture by the doctor		He Clinic (international medical center)
Echosalpingography (ultrasound)		Clinic "Lama" (center of operative gynecology)
Anesthesia (intravenously)
Reception and examination by a gynecologist	for free
		Clinic InVitro
		Clinic "Family Doctor" Moscow, St. Petersburg

Injection into the cervix
		Polyclinic "Otradnoe"
hydrosonography		Polyclinic "Otradnoe"
Consultation with a gynecologist + ultrasound (echosalpingography)		Center for Reproduction and Family Planning

Operative laparoscopy + hysteroscopy
Sonohysterosalpingography		Center for Traditional Obstetrics
hydrotubation		Center for Traditional Obstetrics

Video: how to check the fallopian tubes for patency

Checking the fallopian tubes for patency begins with preparation:

Treatment of inflammatory processes of the genital organs.
A thorough hygienic toilet.
Taking antispasmodic drugs at a dosage recommended by a gynecologist.

When choosing research methods, consult a gynecologist: find out which one is suitable for your case, ask to justify why. If you are afraid of pain, unpleasant symptoms, discuss in advance the possibility of painkiller injections into the cervical region. Try to calm down as much as possible before the procedure: spasms caused by nervous tension can adversely affect the diagnostic results. You can learn more about the benefits of individual methods for checking the patency of the fallopian tubes by watching the video below.

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