Tubal patency check
The fallopian tube patency test is a method to check whether the fallopian tube is patency. After the vaginal and cervical disinfection, the specific medical equipment or utensils are used to inject the liquid, air or medicine into the uterus through the cervix to determine whether the fallopian tube is patency check: firstly, routinely Disinfect the vulva, vagina, and place a sterile towel to check the position and size of the uterus. Use the vaginal speculum to dilate the vagina, fully expose the cervix; disinfect the cervix and vaginal fornix again, and clamp the anterior lip of the cervix with a cervical clamp to explore the uterine cavity. If a metal catheter is used to fill the catheter with the contrast agent, the air is exhausted; finally, the catheter is inserted into the cervix, and the external cervix is blocked, so that the contrast agent is not spilled, and the contrast agent flows through the uterine cavity and the fallopian tube under fluoroscopy. Photo film. X-ray hysterosalpingography is a good method of examination.Basic Information
Specialist classification: gynecological examination classification: ultrasound
Applicable gender: whether women are fasting: fastingAnalysis results:
1. When the fallopian tube methylene blue is unobstructed, there is no blue liquid flowing out of the umbrella end of the fallopian tube, or there is no blue staining nearby. 2. The colorimetric concentration of the oviduct phenolsulfonate test is 90%-100%.
1. When the fallopian tube methylene blue is unobstructed, there is a blue liquid outflow at the umbrella end of the fallopian tube, or a nearby blue stain indicates that the fallopian tube is blocked. 2, fallopian tube phenolsulfonate patency test is mainly used for the diagnosis of tubal obstruction, colorimetric concentration of 90% -100%, indicating tubal patency; 60% -80% means incomplete blockage, 50% means complete blockage.
1. When the fallopian tube methylene blue is unobstructed, there is no blue liquid flowing out of the umbrella end of the fallopian tube, or there is no blue staining nearby.
2. The colorimetric concentration of the oviduct phenolsulfonate test is 90%-100%.Clinical significance
1. When the fallopian tube methylene blue is unobstructed, there is a blue liquid outflow at the umbrella end of the fallopian tube, or blue staining in the vicinity indicates obstruction of the fallopian tube.
2. Fallopian tube phenolsulfonate patency test is mainly used for the diagnosis of tubal obstruction, colorimetric concentration of 90%-100%, indicating tubal patency; 60%-80% means incomplete obstruction, 50% means complete obstruction.
People who need to check:
1. Primary or secondary infertility, suspected tubal obstruction.
2. The effect of surgery after tubal ostomy or adhesion separation.
3. After the sterilization of tubal ligation, occlusion, etc., check the surgical results.
4. After the fallopian tube recanalization, the surgical effect is checked and the anastomosis adhesion can be prevented.
5. Treatment of mild fallopian tube obstruction.Positive results may be diseases: fallopian tube lift, hydrosalpinx, tubal obstruction infertility, immune infertility, complications after tubal ligation, tubal obstruction, tubal infertility, tubal adhesions
Taboo before inspection:
1. Fasting for 12 hours.
2. Do not have sex before 3 days.
3. Test at 3d-7d after menstruation is clean.
4, before the inspection should pay attention to the disinfection and cleaning of the vulva.
5. Empty the bladder before examination.
Requirements for inspection:
1. After the test, the patient was banned from the same room and bathed for 2 weeks.
2. Apply antibiotics to prevent infection after the test.
3, lower abdominal pain may occur when injecting liquid, at this time not necessarily too often, after the medical staff can correctly handle it.Inspection process
Tubal ventilation: the injection of carbon dioxide into the uterus via a catheter, 60ml per minute, the pressure does not exceed 27kpa. If the fallopian tube is unobstructed, the sound of bubbles entering the abdominal cavity through the fallopian tube can be heard in the lower abdomen, and the pressure drops rapidly. If the fallopian tube does not work, you will not hear the sound of bubbles, and the pressure will not drop.
Fallopian tube through pigmentation: 20ml of normal saline solution with pigment solution such as phenol red 12mg, inject into the uterus through the catheter, extubate after 10 minutes, urinate after 30 minutes. Colorimetric colorimetry, concentration greater than 90% indicates that the fallopian tube is unobstructed, 60% to 80% means unilateral or partial patency, and less than 50% means bilateral fallopian tube obstruction.
Fallopian tube fluid: 20ml of 025% procaine, slowly injected into the uterus through the catheter, if injected smoothly into 20ml, no resistance, no reflux, indicating that the fallopian tube is unobstructed; if injected 5 ~ 10ml, that is, the resistance is large, the lower abdomen pain, Relaxation pressure, that is, reflux of 10ml, indicating obstruction of the fallopian tube; although there is resistance during injection, it can continue to be injected, with a small amount of reflux, indicating that the fallopian tube is not smooth.
The above three methods are not intuitive. If it does not work, it is not clear where it is blocked.
Hysterosalpingography: The angiography can see the shape and location of the uterine cavity and the shape of the fallopian tube from the screen and photos. For those who are unobstructed, the image extends beyond the port of the fallopian tube, and the dispersion of the contrast agent in the pelvis can be seen on the X-ray film. If the fallopian tube is blocked, the obstruction can be seen. This method also identifies tuberculosis lesions in the endometrium, fallopian tubes, and pelvis.
Laparoscopy: Injecting pigment solution from the uterus into the uterus, laparoscopic observation of the blue veins through the fallopian tubes, spilling into the pelvis, is smooth; if there is obstruction, it can be seen that the blue is stuck, which is the obstruction. In addition, laparoscopic surgery can directly look at the adhesions around the fallopian tubes, adhesion sites, degree of adhesion, and the anatomical relationship between the umbrella end of the fallopian tube and the ovary.
Ultrasound contrast echocardiography: In the lower abdomen B-ultrasound monitoring, 3 ml of sterile saline was injected into the uterine cavity, and the liquid dark area with a anteroposterior diameter of about 06 to 10 cm was observed. Inject 3% hydrogen peroxide 6~10ml, you can see the strong echo of a lot of bubble tumbling in the uterine cavity rolling to the left and right corners, flowing into the fallopian tubes on both sides, overflowing from the two umbrella ends, showing enhanced flaky echoes on both sides of the pelvis, indicating two The lateral fallopian tube is unobstructed. For example, the bubble tumbling echo only stays in the uterine cavity, does not enter the fallopian tube, indicating that the tubal interstitial obstruction; if the bubble rolls over a certain part of the fallopian tube and stops or returns, this is the obstruction; if the umbrella end does not overflow in the pelvis, it means umbrella Blocked at the end.
The latter three methods can detect the obstruction site and are beneficial to the selection of treatment methods.Not suitable for the crowd
1, acute or subacute pelvic inflammatory disease.
2, severe cervical erosion, chronic cervicitis with purulent secretions.
3, fungal, gonococcal or trichomonas vaginitis.
4, pregnancy, menstrual period, irregular uterine bleeding.
5, severe systemic diseases, heart disease, severe infectious diseases, respiratory insufficiency, liver and kidney dysfunction, bleeding disorders, diffuse peritonitis.
6, sexual intercourse within 3 days.Adverse reactions and risks