All methods for studying uterine pipes
Why and who needs the diagnosis of patency of uterine pipes? Modern methods for determining pipe patency: hysterosalpingography (GSG), hydraulic angry, laparoscopy, hysteroscopy. What to choose? Reviews.
One of the main diagnostic moments in determining infertility is the passability of uterine pipes. This test is included in the mandatory key five methods of examination when infertility, in addition to inspection on the chair, as well as ultrasound, infectious and hormonal research.
Each second patient, which treats infertility, detects the adhesion process in a small pelvis or disorder in the work of the uterine pipe.
Diagnostics of the patency of uterine pipes
The uterine tube is, first of all, a peculiar conductor of eggs from the ovary to the uterus. To assess the quality of this transport function of the uterine pipes today there are many methods, and in some cases the passability of uterine pipes can be restored. The main methods to determine the quality of this function are:
- Analysis on determining the level of antibodies to chlamydias (in the blood);
- Collection of anamnesis;
- Hydrosonography;
- Hysterosalpingography;
- Laparoscopy;
- Hysteroscopy.
Hysterosalpingography
This study is carried out in the follicular phase of the cycle on the X-ray apparatus. It allows you to determine:
- The presence of endometrial pathologies (state of the uterus);
- Patency of uterine pipes;
- The presence of malformations (saddot or counya uterus, intrauterine partition, etc.).
With this form diagnostics Possible false-positive, and false-negative results. In comparison with the laparoscopy of discrepancy range from fifteen to twenty five percent. Therefore, the GSG method is considered to be less informative research of uterine pipes than chromosalpingoscopy and laparoscopy.
How is the study:
- The patient is introduced into the cervical cervical channel catheter before the uterine cavity;
- Cavity via catheter Filled with a contrast agent (The substance, in the case of pipes, falls into the cavity of the small pelvis);
- Made Snapshots. One (at the beginning of the procedure) to assess the form of the uterine cavity, the clarity of its contours, the presence of pathology and pipes. The second is to estimate the shape of the pipes and the nature of the spread of the fluid in a little-pelvic cavity.
Advantages of hysterosalpingography:
- No pain relief is required;
- Perhaps outpatient procedure;
- Non-invasiveness of the method (no penetration of tools in the abdominal cavity);
- Good tolerability (discomfort is equal to the installation of intrauterine spirals);
- No complications.
Disadvantages of hysterosalpingography:
- Unpleasant procedure;
- Irradiation of small pelvis organs;
- After the procedure should be carefully protected during the menstrual cycle;
- Lack of one hundred percent confidence in pipes.
Hydrosonography
Widely used technique, allowing to conduct a study with contrast. Highly sensitive, easy tolerant procedure that gives many valuable information.
How is the study:
- The patient lying on the gynecological chair is carried out inspection To clarify the side of the uterus deviation;
- Enter Mirrors in the vagina, after which the cervix exposed Processing;
- In the uterine cavity is introduced thin catheter To study the cervical channel;
- At the end of the catheter, after its introduction, a can be swollen to eliminate the fallout of the catheter from the uterine cavity;
- In the vagina is introduced Ultrasound sensor (vaginal);
- Through catheter introduced warm Fisrators, After that, the fluid comes on phallopy tubes.
Advantages of hydraulic survey:
- No x-ray irradiation;
- The ability to conduct real-time research;
- A clearer detection of hydro or sanosalpins;
- Lighter portability of the procedure than with GHG;
- This technique is safe, in contrast to GSG, after which it should be carefully protected.
Disadvantages of hydrosonography:
- Low results accuracy in comparison with GSG
Laparoscopy
Laparoscopy – Modern method of surgical operation for inspection of organs from the inside without a cut and with a gastroscope (laparoscope). It is performed for the diagnosis of diseases and the study of the organs of the small pelvis and the abdominal cavity, as well as for surgical treatment.
Indications for laparoscopy:
- Infertility during the year (subject to sexual permanent life without the use of contraceptives);
- Hormonal pathology;
- Ovarian tumors;
- Myoma uterus;
- Suspicion of sleeping process or endometriosis;
- Peritonean endometriosis (appendages);
- Polycystic ovarian syndrome;
- Voluntary sterilization (pipe bandage);
- Suspicion of apoplexy of the ovary;
- Suspected ectopic pregnancy;
- Suspicion to twisted the tumor leg of the ovary;
- Suspicion of uterine perforation;
- Suspected pyosalpinse break (or ovarian cysts);
- Loss of Navy;
- Acute salpingoophorite in the absence of results from conservative therapy for 1-2 days.
Benefits of laparoscopy:
The benefits of the procedure are indisputable with the necessary experience and qualifications of specialists.
- Small traumaticity (reducing pain after surgery);
- Fast recovery (one or two days) of physical functions;
- Reduced risk of adhesions after surgery;
- A short period of stay in the hospital;
- The advantage in the cosmetic sense: less noticeable traces from punctures (5-10 mm) compared to the scars after open operations;
- Reducing the risk of developing hernia after surgery, due to the absence of wide dissection of tissues;
- Profitability (despite the higher cost of the operation), due to the savings of medicines, reducing the time of rehabilitation and the hospital period.
Laparoscopy disadvantages:
- High cost of instruments and technical equipment for the operation;
- Possible specific complications (violation of the functions of the cardiovascular system, pulmonary, etc.);
- Not all experts have sufficient experience for carrying out this operation;
- The risk of damage to the anatomical structures (in the absence of a doctor due qualifications and experience).
GEstroscopy
This procedure is one of the most accurate methods of visual examination of the state of the uterine cavity with a hysteroscope, due to which you can identify intrauterine various diseases.
Features of the procedure:
- Slow introduction of hysteroscope;
- Study with it using the cervical channel, the cavity itself and all the walls of the uterus;
- Inspection of the regions of the mouth of both uterine pipes, with the study of color, thickness and uniformity of the endometrium.
Advantages of hysteroscopy:
- Ample opportunities for diagnosis, due to the inspection of organs from the inside;
- The possibility of performing an accurate diagnosis;
- The ability to detect hidden diseases;
- The possibility of biopsy (to determine the presence of cancer cells or the nature of the tumor);
- The possibility of conducting operations to remove tumors, miom, foci of endometriosis, while maintaining the reproductive properties of the uterus;
- The possibility of timely stopping bleeding and preserving important bodies during the operation, as well as the overlay of micro-seams;
- Safety for neighboring organs;
- Minimum risk of subsequent complications;
- Opportunity for regular control over the development of diseases;
- The ability to carry out a gentle abortion, safe for subsequent pregnancy;
- Aesthetics (no scars).
Disadvantages of hysteroscopy:
- Limit of action. Using hysteroscopy, you can effectively solve problems associated with cervical diseases and the uterus itself. Other reproductive system bodies with this method are not solved, laparoscopy is provided for them.
Women’s reviews:
Zhanna:
Made a laparoscopy a couple of years ago. Of the advantages: quickly recovered, scars – minimum, rehabilitation is also fast. Of the minuses: very expensive, and adhesions were formed. Pre-put primary infertility and endometriosis, sent to laparoscopy … And I really wanted a duct. So I had to agree. The first day handed over the tests, on the second – already operation. Forty minutes did, anesthesia – common. Pain after the operation was almost no, so – it pulled a little bit, and all. They discharged in a couple of days, they gave valuable instructions, the video was shown with the operation. ?? What is there to say here … And what is there to say, if today my karapusik is already a year. ?? In general, those who are going to this operation – do not be afraid. And money – nonsense, when such a goal. ??
Larisa:
Laparoscopy had to do about ten years ago. In principle, you come very quickly, you start walking too fast. At first, the ovary cyst found on the ultrasound, endometriosis was supposedly supposedly. Everything went fine. When you started stitching, I woke up. ?? Cuts are small, almost never hurt, on the second day in the evening already calmly got up. From the anesthesia and then he was heavier, the head was circling. ?? In general, it is better not to do operation at all. But this I experienced normally. ??
Olga:
And I did hysteroscopy. What is good – under local anesthesia, and the diagnosis is clear. According to the results of the ultrasound, the endometrium polyps were found and persuaded to remove that I could then give birth normally. Said the procedure is one of the most gentle. I did not want to scrape the uterus, as with an abortion, so agreed. Everything did not work out as promised. Anesthesia I screamed the spinal, the local did not give. In short, it turned out that the hysteroscope is diagnosed with them, as a result, they threw me in almost. The result is upset. So find out in advance what apparatus are going to do hysteroscopy. To then without consequences, and immediately remove all as much as possible.
Yulia:
I have hysteroscopy passed without noise and dust. ?? Aged 34 years. Lived here too .. ?? After reading the Internet, it did not fall in faint, it was scary to go to surgery. But everything went well. Preparation, anesthesia, woke up, day in the hospital, then home. ?? There was no pain, there were no bleeding, and most importantly – now you can think about the second kid. ??
Irina:
I decided to share my experience GSG. ?? Suddenly, who will be useful. ?? He was afraid of scary. Especially reading the comments on the network about this procedure. She took, by the way, no more than 20 minutes. When entering the tip in the uterus it was terribly unpleasant, and when the solution was injected – I did not feel anything. I was waiting for what is about to faint from pain. ?? Until the doctor said – look at the monitor, you are fine. ?? Blowing air – too, in principle, without sensations. Conclusion: do not be afraid of anything, everything will be fine. The study is very important, it makes sense.