Tubal Disease
Tubal disease is a disorder in which the fallopian tubes are blocked or damaged.
One of the many causes of infertility is tubal disease, in which your fallopian tubes become blocked or damaged. Scar tissue resulting from endometriosis or abdominal or gynecological surgery (bowel surgery, cesarean section, ruptured appendix, etc) can block the egg from entering or traveling down your fallopian tube to meet the sperm. Infections, such as Chlamydia, can damage the cilia (tiny hairs lining the fallopian tubes) that help to transport the egg. Without normal cilia, the egg may not meet the sperm, or if an egg becomes fertilized, it may not be able to travel to the uterus. This can result in an ectopic pregnancy, which can further damage your tube.
Tubal ligation (having your “tubes tied” to prevent pregnancy) can also leave your fallopian tubes damaged. However, reconstructive surgery to reverse tubal ligation is often successful.
How tubal disease is diagnosed
Your medical history and a pelvic exam are necessary in diagnosing tubal disease. However, other tests are needed to confirm the diagnosis. You may need one or more of the following tests:
- Sonohysterogram—a procedure that uses ultrasound to detect masses in your uterus that may be blocking your fallopian tubes
- Hysterosalpingogram—a procedure that uses x-rays and a special dye injected into your fallopian tubes to see if they are open or blocked
- Laparoscopy—an outpatient surgical procedure in which your doctor uses a narrow fiber optic telescope inserted through an incision near your navel to look for and sometimes remove scar tissue or endometrial tissue blocking the fallopian tubes
- Falloposcopy—a procedure in which a tiny fiber optic endoscope is threaded through your fallopian tubes, allowing the surgeon to see the insides of the tubes
Questions & Answers
Q. What treatments are available to me?
A. If scar tissue in or around your fallopian tubes is causing the problem, your doctor can often remove it surgically. If your fallopian tubes are damaged, your doctor may be able to repair them using surgery, depending on the type and extent of the damage. If your tubal disease is severe, you may want to consider in vitro fertilization (IVF)—a procedure in which eggs are removed from your ovaries, mixed with your partner’s sperm, and then placed into your uterus. IVF bypasses your fallopian tubes.
Q. What can you tell me about reversing tubal ligation?
A. Reversing your tubal ligation is major surgery that is most frequently performed by laparotomy through an incision in the abdominal wall. It is a lengthy procedure that often requires the use of a surgical microscope (called microsurgery). You can expect a stay in the hospital and a few weeks off from work. It will be several weeks before you can resume your normal activities.
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