Salpingo-ovariolysis.

Salpingo-ovariolysis is a procedure that involves invasive intervention to restore patency of the fallopian tubes. This is one of the methods for treating obstruction of the tubes, including a method for treating infertility. The main elements of this procedure should be known to a woman before it is performed.

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Epidemiology

Statistics show that most often tubal obstruction can be caused by an infection, such as pelvic inflammatory disease. The probability of tubal infertility is 12% after one, 23% after two and 53% after three episodes of infection. The higher the degree of adhesions, the more effective the procedure is salpingo-ovariolysis. The complication rate of this procedure is less than 4%, compared to other treatments, which proves the effectiveness of this procedure.

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Causes fallopian tube obstruction

The causes of salpingo-ovariolysis are the formation of adhesions between the woman's ovary and fallopian tube, or between these organs and the pelvic peritoneum, which this procedure can eliminate. Today, infertility is widespread among young women, and one of the causes may be obstruction of the fallopian tubes.

The fallopian tubes connect to the uterus at the uterotubal junction, where the fallopian tubes open into the uterine cavity. These very thin tubes are lined with cilia, which are hair-like cells. From there, they widen and extend slightly toward the ovaries on either side. When the oocyte (egg) is released during ovulation, the fimbria and cilia guide the oocyte into the fallopian tube to travel toward the uterus so fertilization can occur.

When adhesions form on one side or both sides, this completely disrupts the ovulation process, and accordingly complicates the process of normal release of the egg and fertilization. Only dissection of adhesions can become the only possible method of treating the pathology.

What are the causes of adhesions? Common causes that can cause blocked fallopian tubes are:

1. endometriosis;
2. pelvic inflammatory disease;
3. uterine fibroids;
4. ectopic pregnancy;
5. tubal ligature removal;
6. complications from another abdominal surgery, such as a cesarean section.

Fallopian tubes can become blocked when adhesions (internal scars) form after the body heals from surgery, infection, endometriosis, or repeated injury. Women who have had surgery or infections such as pelvic inflammatory disease or chlamydia are at increased risk of developing adhesions that can block their fallopian tubes.

Endometriosis, which is often accompanied by adhesions, is another important cause of tubal blockage. Repeated traumatic events such as physical or sexual abuse, accidents and falls, or sports injuries can also cause blockage in one or both tubes. Other causes include vaginal and yeast infections and sexually transmitted diseases.

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Pathogenesis

The pathogenesis of further complications is that all of these conditions can cause blockage of the fallopian tubes by the formation of adhesions, scar tissue, tumors, or polyps within the tube pathway. The damaged fallopian tubes can twist or the walls of the tubes themselves can stick together, causing a complete blockage. The formation of adhesions may not necessarily block the fallopian tube, but may make it dysfunctional by distorting or separating it from the ovary. Therefore, in such cases, the salpingo-oophorolysis procedure may be the treatment of choice for the pathology.

Based on this, risk factors for the development of pathology are previously undergone surgical interventions, infections, frequent abortions, as well as any invasive procedures on the uterus.

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Symptoms fallopian tube obstruction

There are actually no outward signs that will let you know if you have blocked fallopian tubes. If you have ever suffered from pelvic inflammatory disease, however, there is a very good chance that you have this process.

The first signs of pathology in women of reproductive age are the inability to become pregnant. Symptoms that prove the need for salpingo-ovariolysis in this case are habitual miscarriages, ectopic pregnancies, and bilateral salpingo-ovariolysis. Salpingo-ovariolysis on both sides is a dangerous pathology, since it significantly reduces the chance of a normal pregnancy. In such cases, drug-based non-invasive treatments are often ineffective, so salpingo-ovariolysis is the method of choice.

Diagnostics fallopian tube obstruction

Before carrying out this procedure, it is necessary to accurately determine the presence of obstruction, its possible cause, and its location.

Diagnostics can be quite broad. Various methods are used, mainly instrumental diagnostics.

Diagnosis of blocked fallopian tubes

1. A hysterosalpingogram is an x-ray test that uses a contrast dye to look for any blockages in the fallopian tubes. A radiolucent dye is injected into the uterine cavity through an ointment. The dye then fills the uterus and travels into the fallopian tubes. If there is no blockage in the fallopian tubes, the dye will show up on an x-ray, showing the uterus and tubes. There is a small percentage of false positives, where the x-ray shows a blockage where there is none. If the doctor suspects this, he or she may order the procedure to be repeated.
2. Chromotubation – This test is similar to a hysterosalpingogram because it involves dye passing into the uterus and fallopian tubes. This test is done during laparoscopy so doctors can see the dye breaking down from the fallopian tube. The dye used for this procedure cannot be seen on an x-ray and is blue. This test is considered the most reliable way to determine if the fallopian tubes are blocked, but it requires surgery.
3. Sonohysterography is a noninvasive procedure that uses ultrasound imaging to determine if there are any abnormalities in the reproductive organs. This type of test is not always a reliable way to determine if the fallopian tubes are blocked because the tubes are so small. This test can help determine if there is a hydrosalpinx or other problems, such as uterine fibroids.
4. An ultrasound can detect blockages when the fallopian tubes are inflamed. Ultrasound works by using high-frequency waves to create an image of the internal organs on a computer.

Tests that can be used to diagnose pathology include general and specific blood tests for the presence of infectious agents.

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Differential diagnosis

Differential diagnosis can help to identify the cause, which can serve as a basis for choosing a treatment method.

Treatment fallopian tube obstruction

Today, salpingo-ovariolysis can be considered one of the most common methods of treating fallopian tube obstruction. But before considering this method, it is necessary to find out what alternatives there are to drug therapy.

Traditional medicine is widely used. Systemic enzyme therapy is a method to help the body cleanse itself of excess tissue, scar tissue, purify the blood, improve circulation to the reproductive organs, and reduce the immune response. Enzyme therapy consists of using systemic enzymes (enzymes naturally found in the body) to help the body reduce inflammation, occasional pain, reduce scar formation, and more. Systemic enzyme therapy can help reduce scar tissue that is blocking your fallopian tubes. Specific systemic enzymes help reduce fibrin (the material that forms scar tissue) over time. This type of therapy shows great promise in helping the body reduce excessive scar formation and inflammation.

Physical therapy is also widely used. Massage is another natural therapy that can help maintain fallopian tube health. One of the greatest benefits of massage is its ability to break up adhesions. Adhesions are made up of scar tissue. These adhesions are what cause the fallopian tubes to become blocked, stuck together, or attached to other parts of the reproductive organs or other internal tissues of the body. Massage provides a great non-intrusive option for women with blocked fallopian tubes. Massage helps break up scar tissue and increase the amount of circulating fluid in the elimination of tissue. Self-massage can be used. This is a massage technique that is used to support reproductive health, the menstrual cycle, and your fertility. This type of massage is easy to do and is cost effective.

Castor oil treatments have been used for centuries to help treat problems throughout the body, including the reproductive system. Treatments include castor packs, which are cloths soaked in castor oil that are placed on the skin to improve circulation and promote healing of the tissues and organs beneath the skin. Castor oil helps the fallopian tubes by helping to soften the tissue and increase circulation in the area.

Castor oil promotes healing of the reproductive system by stimulating blood circulation and accelerating lymphatic drainage. The lymphatic system is responsible for removing metabolic waste, old diseased cells and tissue. This is very important, especially if blocked fallopian tubes can be caused by ectopic pregnancy, sexually transmitted diseases, infection from previous surgeries, endometriosis, uterine fibroids, ovarian cysts.

Castor oil is one of the only ways to stimulate the lymphatic system. This therapy works great in combination with any type of massage, including self-massage.

Herbal treatments can be used in combination with other methods. There are many herbs that have traditionally been used to support the health of the fallopian tubes. Herbal medicine classifies herbs by their different types of actions. Anti-inflammatory herbs help reduce inflammation, which in turn reduces pain and helps reduce further scar tissue production. If inflammation persists in or around the fallopian tubes, scar tissue can form. One such herb is chamomile infusion. This can be simply brewed by adding a bag of chamomile to a glass of water. Take three times a day instead of tea.

There are herbs that help increase blood flow through the reproductive organs. Healthy circulation will bring vital nutrients, enzymes, and oxygen for cell healing. Once the cells have used up what they need, renewed, or replaced old damaged or unhealthy cells, metabolic waste (damaged tissue) is removed from the body. Coltsfoot infusion is very effective in this regard. Coltsfoot has an extremely high antioxidant content, improves the integrity of the blood vessel wall, helps the body in the proper use of oxygen, and improves circulation. To prepare, pour boiling water over the herb and let it steep for twenty minutes, then cool and drink a teaspoon five to six times a day.

Ginger root is a wonderful herb used to increase circulation and promote blood flow to the reproductive organs. Increased circulation also helps reduce inflammation of the uterus, ovaries, or fallopian tubes. For treatment, use a concentrated solution - soak the root in 30 grams of boiling water and take a teaspoon three times a day.

Homeopathy can also be used in treatment. The following remedies can be used.

Hydrastis canadensis root. This root has extremely strong antibiotic, antimicrobial and anti-inflammatory properties. It helps to heal any infection in the reproductive system while reducing pain and inflammation from external tissue growth. Reducing inflammation can help prevent scar tissue and adhesion.

Angelica sinensis root is one of the best herbs for stimulating blood circulation in the reproductive organs. It has both analgesic and anti-inflammatory properties.

Arctostaphylos uva ursi is one of the best herbs for reducing fluid retention and congestion. This herb has been shown to be effective in combating vaginitis due to its antimicrobial activity. Uva ursi helps the body in removing excess fluids for daily detoxification.

Surgical treatment may be one of the methods. Depending on the location of the blockage, different methods may be used.

If the fallopian tube is blocked early on, minimally invasive techniques such as transcervical balloon tuboplasty can be performed. In this procedure, a tiny balloon catheter is inserted into the tube to open it.

Mid-tubular or distal blockage: When the fallopian tube is blocked further outside the uterus than the entrance, the task of surgically opening the tube becomes much greater. Unable to be achieved by simply “clearing” the tube accessible through the uterus, doctors are forced to perform a more invasive procedure to open the tube.

Laparoscopic surgery is used in most cases as the least invasive method of treatment. Laparoscopic salpingo-oophorolysis is performed as follows.

In this surgery, the patient is put under general anesthesia. Incisions are made - several holes (ports) - in the lower abdomen and pelvis. One port is used to fill the cavity with gas to help separate the organs so the surgeon can create space to insert surgical instruments and access the reproductive organs. Using the other ports, the doctor inserts a light, usually a camera, and surgical instrument(s) to cut out adhesions they see and open and repair blocked tubes.

If the adhesions are extensive, the doctor may perform or switch to an open surgery called a laparotomy. In this surgery, the body is cut open with a scalpel, and the sides are usually separated with a metal retractor. The doctor then inserts a scalpel, laser, or other surgical instrument to cut or burn away any adhesions he or she can find.

Endoscopic salpingo-oophorolysis has several advantages. First of all, it is direct visualization with easy accessibility and minimal invasiveness. The surgeon can directly see the problem and also insert dye to check that the fallopian tube is open.

Surgical procedures can be performed through open abdominal surgery. Salpingectomy is a procedure to remove part of the fallopian tube. This is usually done for hydrosalpinx.

Salpingostomy is a procedure performed when the end of the fallopian tube is blocked. The surgeon creates a new opening in the fallopian tube closest to the ovary. The success of this procedure is often temporary and often causes another blockage within 3-6 months after the procedure.

Selective cannulation is a procedure performed for proximal tubal occlusion. Using hysteroscopy, the doctor inserts a catheter through the cervix, uterus, and into the fallopian tube. It is a non-surgical procedure that has a 60% pregnancy success rate.

Prevention

Prevention of any problem of the reproductive system is preventive treatment of any infections, pregnancy planning and prevention of miscarriages.

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Forecast

The prognosis for uterine obstruction can be favorable if the problem is identified early. The prognosis for pregnancy can also be favorable with the right comprehensive approach to treatment. Salpingo-ovariolysis is the most acceptable non-invasive procedure that reduces the risk of complications and improves the prognosis for pregnancy after uterine obstruction.

Salpingo-ovariolysis is a procedure used for uterine obstruction and can be the number one treatment. If a woman is planning to become pregnant in the near future and has a problem with obstruction of the tubes, then in addition to the etiological solution, salpingo-ovariolysis is the most accessible and fastest method of treatment.

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