Free Medical Advice Related to Laparoscopic Surgery

Tubal Block
Discussion in 'All Categories' started by Carolina - Nov 12th, 2015 6:53 pm.
Carolina
Carolina
I am 36, heterosexual female. I have been diagnosed with hydrosalphinx bilateral. and i do have some adhesions on August 31. I did my HSG and it was great in 2013.

But since than i discovered i had hypothyroidism, by using Euthyrox 25mg for two months i got my TSH below 2.7.

I also have polycistic ovaries, regular ovulation and periods in the time span of 28-32 days, I have a high AMH, my FSH is higher than LH. I'm 5 foot 8 inches tall (172cm) and my weight is around 77 KG.

I would like to try to preserve my natural fertility if possible in any way I can and I am considering a laparoscopic surgery that could potentially fix my tubal blockage or a microsurgical procedure.

Please see enclosed hospital discharge list, my ultrasound (which i have to repeat i might have a cyst on my right ovary and will do so on the 4th day of the cycle which i can send to you later on), my AMH level and i can enclose anything else you would need to tell me what sort of surgery do i need and when should i do it, what is the name of the procedure, rate of success and how much it would cost me.

The surgeon who did my laparoscopic diagnostic surgery didn’t answer any of my questions (some of them were – what are the fimbria like in my hydrosalphinx or fallopian tubes), where is the hydrosalphinx (is it distal or proximal tubal blockage??), how did my ovaries appear, what sort of adhesions do I have).

The surgeons here are not very well equipped and I think there is only Valjevo where they do laparoscopic tubal reconstructive operations, but from what I read they do not do it especially good, because they do not stitch it thoughtfully, or because of the lack of knowledge, but the tubes quickly glue itself back together.

My second question is: when, where and what sort of tubal opening or repair surgery would I do and when? I need a skillful surgeon for a laparoscopic, microsurgical or what sort of operation? Also, when should I do the operation? How can I avoid the tubes gluing to each other after the surgery?

Do I have proximal, distal or what sort of tubal blockage? Also, I would like to ask, if I am in the situation where my fallopian tubes are removed how much would that affect the production and the quality in my ovaries (I have hypotheroidis and PCOS since 2013). I really hope this will not happen, as I am considering tubal repair surgery very much at the moment.

I found also like to ask you what is the price for this type of surgery (opening the tubes) and maybe the cost of opening the tubes, treating the adhesions (which are web like) and the ovarian cyst if it does not go away soon.

I do not know which type of tubal blockage i have, but am i a candidate for Fallopian Tube Recanalization, or which type of procedure? When can i attempt pregnancy after the surgery either naturally, by insemination or maybe ivf (with my tubes kept by this operation).

What is the price for the operation at your clinic, what type of the procedure is it, what is the success rate and how much does it cost?

I am sending you also 2 ultrasound scans I did here in the end of October and the other I did on 10th November my day 4th of the cycle.
So, I will take care of the cyst on my right ovary (it happened while I was doing some bioenergy treatments) I hope it should be fine. I’m sending you ultrasounds of that as well, on the first one it looks like a yellow fluid (post-ovulation cyst and some kind of separation cyst), on 10th November i did a color Doppler on day 4th of the cycle, my right ovary could be seen as a 8mm portion of hydrosalphinx (the cyst is probably blocking it). I did my papanicolau test in July, which was fine, blood work in August, and on color Doppler the cyst didn’t show any blood vessels or arteries going thru it. Nevertheless, I will do CEA 215 and HE 4, Roma index markers and maybe CEA and betaHCG.

Because of the adhesions, etc. I think I will need a very skillful and experienced surgeon. Do I need salpingectomy/fimbrioplasty, or what sort of reconstructive surgery should and can I do and where for a price I could afford.I think i have a distal tubal occlusion on my right side, and on the left side i have a hydrosalphinx which my surgeon did not describe (i think it's on my middle part of the tubes, considerably smaller it can not be seen on ultrasound, it was seen during laparoscopy (do i need a reastanomisis for my left fallopian tube)?

Also, what sort of knots should one use in treating the distal occlusion, what sort for middle tubal blockage, should a surgeon use Co2 laser or micrsurgical laser, what should be avoided?

At the moment i am doing acupuncture, with some herbs, but i decided to do tubal reconstructive surgery so i can give myself a chance to attempt natural pregnancy because i want a larger number of children.
If u need anything else from my medical reports, i can sent it to you.
re: Tubal Block by Dr R K Mishra - Nov 12th, 2015 7:14 pm
#1
Dr R K Mishra
Dr R K Mishra
Dear Madam,

The exact location of tubal bock non of the test except laparoscopic tubal patency test by laparoscopy can detect. If you have video of previous diagnostic laparoscopy by seeing it we can draw some conclusion otherwise we have to do laparoscopy again. If during laparoscopic surgery the tube will be found patent and healthy, it is well and good. If there is proximal obstruction we can open it by hysteroscopy during the same time. If we will found that it is distal obstruction at fimbrial end we can do fimbrioplasty and if severe hydrosalpinx with salpingitis will be detected we have to remove the diseased tube so that normal tube can work better. If both the tubes are completely damaged and inflamed it is better to perform bilateral salpingectomy followed by IVF. These decision can be taken only at the time of surgery. There is no way of giving prior commitment. We will record the entire video of the surgery and we will show you every thing what we have done and what should be future course. Unfortunately fallopian tube is too soft to see the exact exact block by any other investigation. As far as the PCOD is concern we can do ovarian drilling at the same time. The success rate depends upon the anatomical deformation. The entire surgical package of this procedure will cost you only 3000 USD including everything and you have to stay only one day in hospital.

With regard

Dr R K Mishra

World Laparoscopy Hospital
Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India
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re: Tubal Block by carolena - Nov 13th, 2015 3:56 pm
#2
carolena
carolena
Is tubal patent laparascopy test dangerous? On some places i read that this test can damage the tubes? How exactly is it done? Do u use some type of cannula?
I thought i needed neosalpingostomy/fimbrioplasty and a reastanomisis for my left tube? I'm scared of the word hysteroscopy - what exactly is it and why is it needed for a hydroslaphinx.
Could i ask you for my cyst. My mother saw my gynegologist today, and she still claims it's a 'yellow body' cyst. How should i manage the cyst?
I saw yr operation on youtube for dermoid cysts and was impressed.
So, would i have a cystectomy as well via laparoscopy?
I also heard that ovary drilling can be dangerous. To my knowledge my left ovary is fine, i have ovulations, the last time it should 11 folicules. What would i gain by ovarian drilling? What could i benefit from that?
Is the price of the hospital stay included?
Can i also ask if u don't mind what kind of stiches do you use for distal occlusion and what kind of stiches for reastanomosis? Do you make the new fimbria opening by turning them outside and stiching them or by using laser and making a flower opening. If so what kind of laser do you use?
I think that i could do some money raising and afford the procedure. But i apsolutely want to do everything i can to preserve my tubes so i can try natural conception and ivf if necessary (with my tubes kept).
You answered most kindly and precisely and i really thank you for that.
I would like to ask why do i need a hysteroscopy? I'm really scared of that word.
So, we'll be in touch. If i have additional questions, can i call you.
Tomorrow i'll be doing some tumor markers as well.
Should i repeat an ultrasound, and how should i manage the cyst.

Thank you very much dr R. K. Mishra and we'll be in touch.
re: Tubal Block by Dr R K Mishra - Nov 13th, 2015 4:05 pm
#3
Dr R K Mishra
Dr R K Mishra
Tubal patency test and hysteroscopy both is safe. You can see our this procedure in YouTube. Repeating ultrasound does not give you any benefit. On tube we use surgeons knot with 4-0 vicryl. Managing Cyst PCOD ovarian drilling is safe procedure in experienced hand.
re: Tubal Block by Carolena - Nov 17th, 2015 9:24 am
#4
Carolena
Carolena
If it's ok with you, i will call u on WHL by phone if anything is not clear with me.
I read somewhere that neosalpignostomy/fimbriplasty can only be duable or efficient (i thought mucosa) but corpus fimbriatum is preserved? Please, with respect view this questions neutarally - I chose not to do ovarian drilling for different reasons, could we use 5-0 vycril stiches (because they disolve after 50-70 days and i feel better with the option). I feel that it would be done with 4-0 stiches which are disposable after some 72 hrs, there would be a chance or not? for my tube endings and tubes to glue back together?
Is there a chance we could use 5-0 vycril for neosaplingostomy/fimbriplasty?
What is the price of this procedure without ovariallian drilling?
Also, view this neutarally - how many stiches do you make (is it 4?) for the new tubal opening?
If my cyst is still there, what would be the price of neosalpingostomy/fimbrioplasty with cystectomy?
How much does 2 day hospital stay cost? Do you maybe have a youtube recording of a neosalpingostomy which u did? I'm also sending you my tumor marker results for ovarian and uterus cancer, i did my PAP test in July and will get new results tomorrow.
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