This can occur after infection such as complications from abortion, missed miscarriage, cesarean section or PID. Permanent birth control procedures like Essure block the isthmus.
What is Midsegment tubal obstruction?
It is most often due to tubal ligation damage. Tubal ligation removal comes with its own risk for development of more scar tissue on top of scar tissue already present from the initial tubal ligation procedure.
What isDistal tubal occlusion ?
It is the type of blockage that affects the part of the fallopian tube end towards the ovary. This type of blockage is typically associated with hydrosalpinx. . caused by Chlamydia trachomatis infection, which is a sexually transmitted disease.
What are the Common conditions that may cause blocked fallopian tubes ?
Pelvic Inflammatory Disease (PID).
Tubal Ligation Removal.
Complications from lower abdominal surgery such as Cesarean section.
Genital Tuberculosis (still common in developing countries, especially India).
What is tubal cannulation?
Tubal cannulation is a procedure used to help clear blockages in a woman's fallopian tubes.
Blockage is a common cause of female infertility because the fallopian tubes are vulnerable to infection and surgical damage. Between 12 - 33% of infertile couples experience a blockage, which affects the woman's ability to get pregnant.
What is hysteroscopic tubal cannulation ?
A relatively new method for treating proximal tubal obstruction is that of hysteroscopic tubal cannulation.. . this kind of block is often because of mucus plugs or debris which plug the tubal lining at the uterotubal junction which is as thin as a hair. It is now possible to pass a fine guidewire through the hysteroscope into the tubes, and thus remove the plug or debris and open the tubes - thus restoring normal tubal patency with "minimally invasive surgery"!
What is Nuchal Translucency (NT) scan?
Its done at 11-13 WEEKS
A Nuchal fold scan gives a risk assessment of your baby having Down's Syndrome or other chromosomal abnormalities. An assessment based on the mum-to-be's age, the thickness of the nuchal fold at the back of your baby's neck, your baby's nasal bone and a blood test.
If there is a high probability, then you might need to take further tests such as an amniocentesis test to get a definite answer. You and your partner will be able to discuss this fully with your doctor.
How long is the recovery period?
After a hysteroscopy, patients often have cramping similar to that experienced during a menstrual period; and some vaginal staining for several days. Regular activities can be resumed within one or two days after surgery. Sexual intercourse should be avoided for a few days or for as long as bleeding occurs.
What are the benefits of cannulation?
Tubal cannulation is a procedure that can help open the fallopian tubes. It is successful in 80 - 90% of cases. The procedure is less invasive than fallopian tube surgery and because of its simplicity, it's considered a first line treatment for fallopian tube blockage.
Which part of the tube can be reached with this procedure?
The cannulation procedure is most successful when the blockage affects the part of the tube closest to the womb (uterus). This is known as a proximal tubal obstruction.
Who should not have tubal cannulation?
Tubal cannulation may not be recommended if you have:
Extensive scarring in the fallopian tubes
Genital tuberculosis and certain other infections
Previous fallopian tube surgery
Severe blockage that makes it difficult for a tube to pass through
Severe damage to the fallopian tubes
When it can be unsuccessful?
Tubal cannulation may be unsuccessful, or may not work as well if you have:
A blockage in a part of the fallopian tube far away from the uterus
Certain blockages in the narrowest part of the fallopian tube
Inflammatory condition of the fallopian tubes -
Severe tubal disease or scarring OR Tuberculosis
What to expect after tubal cannulation?
Tubal cannulation is successful in restoring fertility for many, but not all, women. It is important to remember that unblocking the fallopian tubes does not always help a woman become pregnant.
What are the factors considered for the success of the procedure?
Type of procedure performed
Location of the blockage
Cause of the blockage
Why opting for this?
Hysteroscopic cannulation for proximal obstruction is a procedure with minimal morbidity and a reasonable successful recanalisation rate.
It should be considered as an alternative to in vitro fertilisation.
What are the other options for proximal block?
Tubotubal anastomosis and tubal implantation onto uterus.But these are tedious,prolonged,postoperative longer recovery period and hospitalization and adhesion formation.Whereas hysteroscopic cannulation doesnot require incision,reduced hospital stay,faster recovery,no blood loss,achieves higher pregnancy rates about 80-90%.
What is HSG ?
A hysterosalpingogram, or HSG is an important test of female fertility potential. The HSG test is a radiology procedure usually done in the radiology department of a hospital or outpatient radiology facility.
Radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix
The uterine cavity fills with dye and if the fallopian tubes are open, dye fills the tubes and spills into the abdominal cavity
This shows whether the fallopian tubes are open or blocked and whether a blockage is at the junction of the tube and uterus (proximal) or at the other end of the tube (distal).
What is SSG?
Sonosalpingography (SSG), also known as Sion test, is a diagnostic procedure primarily used for evaluating patency of fallopian tubes.
What are the added advantages of this?
Advantages of tubal catheterization include it being an effective triage for patients with tubal disease, the avoidance of contrast allergies, and the avoidance of radiation, as well as the avoidance of laparoscopy in selected patients. This approach is superior to proximal tubal micro-reanastomosis when successful and superior to IVF when successful. There are low complication rates for this procedure.
Hysteroscopic cannulation should be first choice in the management of proximal tubal obstructions in selected patients. It may be a treatment option for delayed occlusion after successful cannulation or resection anastomosis.
What to be considered for women with severe tubal disease?
Women with severe fallopian tube disease who are not good candidates for tubal cannulation may consider IVF and embryo transfer as an alternative.