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A woman’s reproductive capacity can be easily shaken. It is influenced by lifestyle and nutrition, health status, diseases of the genital organs. In the process of conception, the fallopian tubes play an important role, pathologies of this part of the female body lead to long-term treatment, and sometimes to infertility. To diagnose their condition and functionality, a special technology is used – falloscopy.
What’s this
Falloscopy is a way to see the inner surface of the fallopian tube, to assess its lumen (patency). For normal reproductive ability in a woman, all departments of the internal genital organs must function. Fallopian tubes are also called fallopian, oviducts or salpinx. They serve as a direct route for the egg from the ovary to the uterus. Promotion of the egg occurs due to the fleecy epithelium and muscle contractions. Any pathology in the pipes can interfere with movement: adhesions, epithelial disorders, fluid in the lumen of the pipe, etc.
It is in the fallopian (fallopian) tubes that fertilization occurs. The egg is released from the ovary, enters the funnel of the tube and moves along it. When planning a pregnancy, this egg meets the sperm and moves on to the uterus, where it remains to form the fetus. If the tubes are damaged in any way, tubal infertility occurs. Unfortunately, it is not always possible to restore the structure and functionality of this department. However, in most cases, doctors still return women the opportunity to procreate.
There are many ways to detect a problem in the fallopian tube area. The primary diagnosis is X-ray with contrast. A substance with iodine is injected into the uterine cavity with a special syringe, it does not transmit x-rays and the organ is clearly visible in the picture. This is the simplest method of examination, but far from the most informative, it is almost impossible to examine the internal structure of organs and mucous membranes. Therefore, invasive techniques are used: laparoscopy, salpingoscopy, falloscopy.
All of them are based on the introduction of an endoscope and instruments into the area of interest. In the case of phalloscopy, a phalloscope is used. This is a device with a flexible tube with a diameter of 0,5 mm, at the end of the tube there are points of illumination and an optical system. By inserting such a device inside the salpinx, the doctor can see any part of the fallopian tube with up to 50 times magnification.
Falloscopy is performed in two ways:
- hysteroscopic;
- laparoscopic.
In the first case, an optical device is inserted into the salpinx through the uterine cavity. You can carry out such a procedure even without anesthesia in the office of a gynecologist-surgeon. The laparoscopic technique is performed in the operating room, while the phalloposcope is inserted into the oviduct through a small opening in the abdominal cavity. Both manipulations allow assessing the condition of the mucous membrane, ciliated epithelium, and peristalsis. With the accumulation of mucous plugs in the tube, shreds of the epithelium, falloscopy also serves as a treatment, as it clears the lumen.
When is a phalloscopy indicated?
The procedure is indicated for women with tubal infertility, which can be caused by various reasons: inflammation, neoplasms, plugs, adhesions. No other diagnostic method provides such comprehensive information about the condition of the tubes as falloscopy. Its main task is to examine in detail the fleecy epithelium of the salpinx. Also, this technique is resorted to when other types of examination cannot establish the cause of infertility. In most cases, this technique complements other methods of examining the patient; falloposcopy can be performed during hysteroscopy, laparoscopy, and salpingoscopy.
Indications for examination:
- Purulent salpingitis is an inflammatory disease caused by bacteria or fungi. In most cases, purulent salpingitis is caused by chlamydia.
- Tumors are benign and malignant neoplasms; they are very rare in the structure of the oviducts.
- Tuberculous salpingitis is an infectious disease, rarely found in developed countries, in the CIS region – more often. Leads to infertility.
- Cysts are a very common disease, they come in different sizes, filled with fluid or without it. It is not always possible to save the tube when removing the cyst.
- Occlusion – narrowing of the lumen of the oviduct, can be in any part of the organ, even in several. Narrowing in the interstitial and isthmic (the narrowest sections) is not restored surgically.
- Synechia – intrauterine adhesion, the formation of connective tissue between the walls of the organ. As well as occlusion, it can be eliminated only in large sections of the pipe.
All of these fallopian tube problems are diagnosed during a falloscopy, and some of them can be treated with the same method. In this case, an examination can be carried out only if the patient does not have an acute course of inflammation. In most cases, after a visual examination and detection of pathology, the doctor prescribes an operation or systematic treatment. Also, such a diagnosis is needed after reconstructive operations to restore the salpinx, but after the rehabilitation period. During the examination, the gynecologist evaluates the quality of the operation and its result, and may prescribe additional treatment measures.
Contraindications for the procedure
A strict contraindication is the acute course of inflammatory diseases. Intervention in this case can only worsen the situation and spread inflammation. For this, the patient is prescribed systematic treatment, after recovery, a diagnosis is made with a falloscope.
Also, this technique does not apply when:
- uterine bleeding;
- cervical cancer;
- stenosis or perekrytii cervical canal;
- acute infectious diseases;
- severe diseases of the cardiovascular and respiratory systems.
Before prescribing such an examination, the doctor must make sure that there is no pregnancy, since it is also a contraindication. Some of the described problems are incompatible with the hysteroscopic method, but are managed by laparoscopy.
Preparation rules
The main rule for preparing the patient is a complete examination. The patient must undergo an examination in the gynecological chair, the doctor determines the location of the uterus, determines possible diseases. They also do ultrasound and x-rays for a detailed study of the structure and location of organs in the abdominal cavity.
A number of tests that a woman takes can eliminate the likelihood of contraindications. These include:
- general blood and urine tests;
- blood chemistry;
- blood clotting test;
- smear from the vagina;
- fluorography of the chest cavity;
- ECG (decoding).
Depending on the condition of the patient and the suspicions of doctors, additional tests may be prescribed. After receiving the results of the studies, the patient is assigned the falloscopy itself. 6 hours before it is forbidden to eat and drink a lot, a cleansing enema is done immediately before the procedure, if necessary.
How will they do it
Falloscopy is prescribed in the first phase of the menstrual cycle, on days 5-7. At this moment, the mouth of the oviducts is best seen. Hysteroscopic technique takes place in the gynecological chair, laparoscopic – on the operating table. With the introduction of the device into the uterine cavity, intravenous sedation is performed, with the introduction through the abdominal cavity – general anesthesia.
With hysteroscopy
The patient sits on a gynecological chair, first the doctor examines and determines the location of the uterus. With the help of vaginal devices, the cervix is moved apart, a hollow tube of the hysteroscope is inserted into it. The uterine cavity is treated with saline, then the expansion is carried out with a liquid or gas. Gas or a special liquid enters the uterus through the tube, which are then removed, they are absolutely safe for the patient. This is necessary in order for the organs to straighten, so it is more convenient to study them.
After that, a hollow tube is inserted with a phalloposcope with optics. The image is transmitted to the monitor with a multiple increase. The doctor examines the condition of the organs, the muscles of the tube, the epithelium. During this process, a piece of tissue may be removed for a biopsy. After examining one tube, they pass to the second one, while the hysteroscope is not removed, the patient remains in the same position. When the oviducts are fully explored, instruments are removed, liquid or gas is removed, the genitals are treated with an antiseptic.
With laparoscopy
This technique is carried out in the operating room. First, the patient is put under anesthesia, when he begins to act, proceed to the operation. Small incisions are made under the navel and on the sides, the abdominal cavity is filled with gas so that the internal organs are better visible. An optical system is inserted into one of them, and hollow tubes with surgical instruments are inserted into the other two. This is a minimally invasive method of operation: instead of a strip opening, only three tiny holes are made.
To examine the salpinx, a phalloscope is inserted into the hollow tube in one of the incisions. The picture is transmitted to the screen and the doctor can examine the area of interest in detail. Also, during this technique, therapy can immediately be carried out if it is needed: remove adhesions, clear the lumen, remove neoplasms. At the end of the process, gas is pumped out of the abdominal cavity, the instruments are removed, and sutures are applied. The patient is under the supervision of doctors in the hospital for some time. If the study was successful, the woman is discharged after a few hours. Both falloposcopy options last no more than 30 minutes.
Procedure results
After the study, the surgeon or surgeon-gynecologist draws up a conclusion. In it, he describes the course of the operation, the condition of all sections of the pipes and the mucous membrane, indicates the presence or absence of pathologies. A transcript of the results is given to the patient in her hands. With these data, she refers to the specialist who ordered the examination. They are usually referred for falloscopy by obstetrician-gynecologists or gynecologists, reproductologists. The procedure is performed by an experienced surgeon. Based on the opinion received, the attending doctor determines how to restore the ward’s reproductive ability and restore her health.
Where can you get this procedure?
Falloscopy is carried out in the gynecological departments of private clinics, in public hospitals, reproductive centers. To conduct such a study, the institution must be equipped with all the necessary equipment. The high price of instruments, endoscopes and computers makes this technique inaccessible to public hospitals. Here they can use the old-style technique, in which the doctor examines the organs through the eyepiece with the eye. This eliminates the possibility of enlarging the study area.
Private clinics are equipped with a new generation of equipment, but the cost of phalloscopy here will be more expensive. One procedure for hysteroscopy will cost 300-500 dollars, how much it will cost depends on the range of work.
If you need a biomaterial for analysis, the cost will be higher, surgical procedures will also increase the price.
Consequences and complications
Invasive interventions are sometimes associated with risks for the patient, falloposcopy is no exception. Reviews of physicians speak of the safety and high information content of this technique. Gynecologists consider it the gold standard in the study of the fallopian tubes.
However, even if all the rules of the procedure are followed, there can be unpleasant consequences. If the study is carried out against the background of an acute course of infections, the intervention will lead to its spread. As complications, the appearance of salpingitis and / or metritis is considered.
In very rare cases, the examination leads to intra-abdominal bleeding. This can happen with perforation of the oviducts or the wall of the uterus. Such consequences are serious, they are eliminated immediately during the procedure. Inflammatory processes after manipulations are treated systematically, with pills or injections. However, experts note that complications are extremely rare.
The procedure itself is also not very popular so far, it is being replaced by x-rays, laparoscopy, HSG and other methods. Nevertheless, it is gaining momentum in a narrowly focused diagnostics – checking the fleecy epithelium. If such a procedure is prescribed, you should not be afraid of it, it passes painlessly and quickly. In addition, this is another way to regain your reproductive ability.