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Adhesions in the fallopian tubes: causes and methods of treatment

Adhesions in the fallopian tubes can be a serious obstacle to the occurrence of pregnancy. They are a consequence of the inflammatory process, localized in the pelvis and are seals of connective tissue.

The smallest fibers of the tissue are spliced ​​together and extend from one organ to another. Adhesions are able to completely block the lumen of the fallopian tubes and spread beyond their limits.

If obstruction is observed in both tubes, then a woman can become pregnant only with IVF or ICSI, if the results of spermograms suggest just such a method of fertilization of eggs.

Content

Causes of adhesions

Inflammation is the main cause of condensation of connective tissue and the formation of adhesions, but the doctor needs to find out what caused it.

Causes of adhesions

This can include both natural factors and mechanical damage resulting from surgical interventions.

There are several causes of adhesions in the fallopian tubes:

  • Abortion, diagnostic curettage.

These surgical procedures involve the separation of the endometrial layer from the inner side of the uterus.

As a result of scraping, an extensive wound surface is formed, and its healing is sometimes accompanied by inflammatory processes, which can later spread to the fallopian tubes.

  • Surgical intervention in the abdominal cavity.

Wound healing after surgery may also be accompanied by an inflammatory process. Especially it concerns those cases when surgical intervention was made repeatedly, after poorly executed first operation.

  • Intrauterine device.

The method of contraception is that a plastic and copper device is implanted into one of the uterine walls. The place where the helix is ​​implanted can become inflamed, this inflammation has a chance to spread beyond the uterus and affect the fallopian tubes.

  • Inflammation of the appendages ( adnexitis ).

It occurs as a result of hypothermia or general weakening of the body against a SARS or flu.

  • Some diseases

Sexually transmitted diseases - chlamydia, ureaplasmosis, gonorrhea. All of them cause the presence of sluggish inflammatory process in the pelvis.

Signs of the presence of adhesions in the fallopian tubes

Signs of the presence of adhesions in the fallopian tubes In some women, adhesive formations do not have pronounced symptoms. Sometimes the problem is found after several years of fruitless attempts to conceive a child or after an ectopic pregnancy.

However, in some cases, the symptoms of the presence of adhesions in the fallopian tubes appear quite clearly:

  • The presence of fluid in the back space according to the results of ultrasound.
  • Periodic pain in the lower abdomen.
  • A slight increase in temperature, accompanied by pain in the abdominal cavity (with acute form).

Diagnosis of the disease

Since adhesions lead to obstruction of the fallopian tubes, it is necessary to diagnose them at the very initial stage of formation. A suspicion of the presence of seals of connective tissue in the pelvis may occur when a doctor compares several results of ultrasound examination of the uterus and appendages performed within six months.

In conclusion, the specialist in ultrasound diagnostics will be marked by the presence of fluid in the dormant space. Normally, this phenomenon can be observed only in the first two days after ovulation.

But if the doctor on ultrasound diagnoses it on different days and different phases of the cycle, then this indicates an inflammatory process in the pelvic organs.

Therefore, you need to check the patency of the fallopian tubes, especially if the woman is planning a pregnancy.

Sonosalpingoscopy (SSS) - the procedure is carried out in the first phase of the menstrual cycle, about 6-8 days Before the study make pain relief with rectal suppositories or injections.

The uterus through the catheter is filled with a special fluid that must pass into the tubes, and then pour into the abdominal cavity. The session lasts about half an hour, and all manipulations and the advancement of the fluid are monitored by ultrasound.

Hysterosalpingography (HSG) - the procedure is carried out in the second phase of the cycle. Immediately before going to the hospital, you need to do a cleansing enema. The doctor in portions introduces a special solution through a catheter that fills the uterus and fallopian tubes.

Monitoring the progress of the fluid is made using x-rays. In addition, compared with the CAS, a more viscous contrasting substance is used in the GHA, so hysterosalpingography can be more painful.

Treatment of adhesions in the fallopian tubes

Treatment of adhesions in the fallopian tubes Since the adhesive process in many cases is asymptomatic, it is already detected in an advanced stage, when the removal of the connective tissue seals will be long and possibly expensive.

Treatment of adhesions in the fallopian tubes involves a combination of drug therapy, physiotherapy and surgery. If the disease has taken an acute form, the doctor will prescribe an observation in the hospital.

Drug treatment

Drugs and injections are indicated when the inflammatory process was caused by urogenital infections or hormonal disruptions. Therefore, drug therapy may be aimed at eliminating the infection or at leveling hormonal levels.

Antibacterial treatment - is carried out when the results of tests show the presence of STDs (chlamydia, cytomegalovirus, ureaplasma, etc.) Antibiotics such as Amoxiclav, Ampioks, Cefalexin are used.

Hormonal treatment is carried out when the results of the examination revealed the presence of endometriosis. The doctor will prescribe the necessary drugs, based on what will show the analysis of hormones.

Physiotherapy

Electrophoresis - activates blood circulation in the pelvis, is carried out during adhesions with vitamins of group B. In this case, the effect of current is directed to the pituitary gland, so that it begins to produce enough hormones.

Then, after the end of this course of treatment, the doctor directs the effects of current directly on the abdomen and electrophoresis is done with the participation of zinc or lidaza.

Hirudotherapy - treatment with leeches. In conjunction with drug therapy has a positive effect and helps to dissolve even a large number of adhesions.

Leech saliva destroys scars resulting from adhesions, makes the seals themselves flexible and moveable.

Surgical treatment

Conservative treatment for obstruction of the pipes does not always help. Therefore, in order for a woman to have a chance to get pregnant, the doctor prescribes laparoscopy of the fallopian tubes.

This surgical intervention is considered to be the most effective in combating the elimination of the consequences of the inflammatory process, but it is prescribed only when other methods have not yielded the desired results.

Laparoscopy is transferred by patients much easier than a full abdominal surgery, and the doctors themselves prefer this method of removing adhesions in the fallopian tubes for several reasons:

  • Small amount of stitches;
  • Rapid healing of puncture sites;
  • Sparing for the abdominal organs nature of the intervention;
  • Highly informative.

During the operation, three punctures are made, then the doctor cleans the cavity of the fallopian tubes and the area around them from adhesions (or ectopic pregnancy, if any) using a video camera and surgical instruments, and then stitches.

Laparoscopy - removal of adhesions in the fallopian tubes

If the tubes are not completely filled with adhesions, then the effectiveness of laparoscopy is 65-70% and after restoration of the fertility of the organ, pregnancy can occur in 3-4 months.

Adhesions and pregnancy

In most cases, adhesions in the fallopian tubes prevent conception of the child, or create a dangerous situation in which the pregnancy becomes ectopic. Fertilization usually takes place in the tubes, and then the fertilized egg drops down into the uterus and implanted in one of its walls.

In the presence of adhesions, the fertilized egg cannot move downward, so she has to implant directly into the wall of the fallopian tube.

If the operation is not performed on time, then this organ is ruptured due to the growing embryo and the woman may die - if the emergency intervention of the medical profession does not prevent the development of peritonitis and sepsis.

If the obstruction is complete, then doctors recommend abandoning independent attempts to get pregnant and start preparing for an IVF procedure.

Classification of the disease according to ICD

The ICD is an international classification of diseases, which is reviewed every 10 years under the supervision and guidance of WHO. The ICD 10 revision is currently valid, which implies the existence of a subsection "Salpingitis and oophoritis" with the code N70.

The acute form of the disease has the code value N70.0; chronic - N70.1; unspecified - N70.9.

It should be noted that ICD assumes only statistical data on diseases, but does not set itself the task of developing specific instructions for treating a disease.

Prevention

Adhesions in the pipes are easier to prevent than to deal with them. Therefore, preventive measures include the following:

  1. Avoid hypothermia of the pelvic organs.
  2. In time to begin treatment of any kind of urogenital infections.
  3. Monitoring the state of the surgical site in the abdominal cavity.
  4. Correct hormonal disorders.

Since the fallopian tubes play an important role in the conception of a child, you need to be very careful about their health. And if obstruction of the fallopian tubes due to adhesions already exists, then planning of pregnancy should be started only after treatment courses and with the approval of the doctor.

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