Tubal Surgery
Overview
Blocked fallopian tubes, known also as tubal blockage or tubal occlusion, prevents sperm from reaching the uterus to fertilize an egg, thereby resulting in infertility. Often caused by diseases such as pelvic inflammatory disease (PID) or endometriosis, tubal blockage can fortunately often be corrected by tubal surgery or by in vitro fertilization (IVF). IVF in essence circumvents the problem of the blocked fallopian tube and uses laboratory procedures to induce fertilization and then transfers the fertilized eggs or embryos into the uterus.
Causes of Tubal Blockage
- PID: Pelvic Inflammatory Disease, a bacterial infection in a woman's reproductive organs typically caused by sexually transmitted diseases (STDs) or other bacterial infections that can result in temporary or permanent infertility.
- Endometriosis: Abnormal growth of endometrial tissue outside of the uterus lining - i.e. along the fallopian tubes, ovaries, or bowels - which can develop into scar tissue and cause infertility.
- Congenital abnormalities that result in tubal blockage.
Types of Tubal Surgery
When fallopian tube obstruction occurs between the uterus and fimbrial end of the tube, tubal surgery removes the blocked section and joins together the two remaining open ends of the tube. This type of tubal surgery is called tubal anastomosis, or tubal reanastomosis, or tubotubal anastomosis.
When blockage occurs where the fallopian tube and uterus meet - known as a proximal tubal occlusion - surgery bypasses the obstructed area, creates a new opening in the uterus, and inserts a non-damaged part of the fallopian tube into the uterine cavity. This type of tubal surgery is called tubal implantation, or tubouterine implantation, or uterotubal implantation.
Tubal Surgery versus IVF
Tubal surgery has certain advantages over IVF - i.e., once fallopian tube blockage is corrected via surgery, a woman can immediately become pregnant. However, tubal surgery carries an increased risk of tubal or ectopic pregnancies. On the other hand, while IVF bypasses risks associated with surgery, the procedure is more complicated, more costly, and runs the risk of multiple pregnancies and ovarian hyperstimulation.
Post Surgery
A brief hospital stay is common after tubal surgery, and antibiotics are administered to prevent infection. Women are typically able to resume daily activities or return to work within four to six weeks, depending on the extent of the surgery and one's personal health. The actual success of tubal surgery - i.e. the ability for women to conceive - depends on factors such as the extent and location of the blockage and the presence of any other fertility problems.
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