|Discussion in 'All Categories' started by SADIQ - Nov 12th, 2011 1:04 pm.|
|my cousin got married 3 yrs before . till not yet form baby. dr's advised , to go to laparscopy treatment.
re: not yet form baby by Dr JS Chauhan - Nov 17th, 2011 8:48 pm
Dr JS Chauhan
|Dear Mr Sadiq
Your patient need tubal patancy test by laparoscopic approach to make out the cause of real infirtility. Tubal patency tests are undertaken once the doctors suspect there are blockages or pelvic adhesions within the fallopian tubes.
Healthy fallopian tubes are an important pre-requisite for conception to happen. If the tubes are completely blocked, the sperm cannot get to the egg to fertilize it. You can definitely, the tubes are damaged and never completely blocked, the sperm might be able to reach the egg, however the early embryo is much more likely to be trapped in the distorted tube - a dangerous condition known as an ectopic pregnancy. As a result it isn't enough the sperm have access to the egg. It's also needed that the egg ought not to be prevented from reaching outdoors end from the tube. When the ovaries are surrounded by adhesions, there is a major barrier between egg and sperm.
The primary reason for tubal obstruction and pelvic adhesions is infection. Infection can be brought on by peritonitis from acute appendicitis, or it may have arisen within the uterus itself as a complication of a previous termination of pregnancy, miscarriage or difficult delivery. In addition, there are a variety of ladies who have chosen sterilization as a way of permanent contraception and alter their marbles for a number of reasons.
About 15 percent of women attending an infertility clinic will have a tubal problem. A perusal from the medical history of half of these women can have no past record of any probable cause of their damaged tubes. In such cases it is possible that a viral infection, even one caught in early childhood, continues to be responsible for the damage.
If there aren't any indications in your history the tubes may be blocked, you'll in all likelihood be given the benefit of the doubt initially while other causes of infertility are investigated. If, however, there is a definite past record indicating possible tubal obstruction, a test of tubal patency is going to be carried out in a relatively initial phase.
Ways of tubal patancy test
1. Gas Insufflation
This is the oldest method of assessing tubal patency and is also known as "blowing the tubes". It's a simple test to handle and does not need a general anaesthetic. An instrument is inserted in to the canal from the cervix and co2 gas is "blown" into the cavity from the uterus. The machine manipulating the flow of co2 also records pressure from the gas as it accumulates within the uterus.
There will be a rise in pressure from the gas inside the uterus if the tubes are blocked. If the tubes are open, the first rise in pressure is followed by an abrupt reduction because the gas escapes along the tubes and in to the abdominal cavity.
However, the outcomes of this test can be challenging to interpret and the test can be unreliable. Furthermore, when the tubes are blocked, the exam gives no details about the location or nature from the obstruction. The inaccuracy of the test has led it to be largely superseded by the following two procedures.
2. Hysterosalpingography (H.S.G.)
A hysterosalpingogram is definitely an X-ray of the uterus and fallopian tubes. An instrument is gently passed in to the canal of the cervix along with a special radio-opaque dye is carefully injected into the cavity of the uterus. The test is performed within the X-ray department and normally doesn't need any kind of general anaesthetic. It can, however, cause you to experience an average amount of discomfort rather like period pains.
The dye shows up on an X-ray screen and also the doctor could see the fluid filling the uterus after which passing along both tubes to go in the cavity of the abdomen. When the dye fails to enter the tubes this might indicate a blockage in the junction between the uterus and also the tubes or just a temporary spasm from the tubes at this site. Sometimes the dye can be seen to go in the tubes, which then become distended owing to an obstruction at their outer ends.
H.S.G. can pinpoint the site of any tubal obstruction and may also show the presence of any irregularity the same shape as the cavity from the uterus. However, this test cannot identify the presence of pelvic adhesions, which may be enveloping the ovaries and preventing eggs from accessing the tubes.
This is a a lot more complex procedure than the previous two tests. It is performed within general anaesthesia and can require your admission to hospital.
A little incision is created at the lower border of the umbilicus. The abdominal cavity is then distended with carbon dioxide gas to create more space to accurately view the pelvic organs. A slim telescope called a laparoscope will be inserted in to the abdominal cavity and also the uterus, tubes and ovaries are thoroughly inspected.
The presence of adhesions either round the tubes or tethering the ovaries can be simply detected, and their significance assessed. Other pelvic problems for example endometriosis and fibroids will also be revealed. Tubal patency is tested by injecting methylene blue dye into the uterus through the cervix. If the tubes are healthy, the dye is visible passing along them and escaping with the outer openings from the tubes.
The great benefit of laparoscopy over H.S.G. is it allows the surgeon to possess a direct look at the pelvic organs and thereby permits a much more accurate assessment of tubal patency and then any tubal or ovarian problems. The requirement for further surgery can be established without having to turn to major abdominal surgery in those days. Nearly all patients can leave hospital the following day. The little operation scar is eventually virtually invisible.
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