7-103 Helios ambulance call +38 067 000 01 50

Examination of Fallopian Tube Patency in Dnipro

Fallopian tube obstruction is a common cause of female infertility. This pathological condition may result from a chronic inflammatory process, the formation of adhesions after surgery, compression of the fallopian tubes by neighboring organs, or congenital developmental abnormalities. Tubal patency can be restored, but first, the condition must be identified and its cause established. Tubal patency testing is a diagnostic service in demand in gynecology, offered by diagnostic centers, reproductive medicine clinics, and other private and municipal healthcare facilities in Dnipro and the Dnipropetrovsk region. Specifically, tubal patency testing is provided at the Helyos Family Health and Rehabilitation Center.

When Is a Tubal Patency Test Needed? The primary indication for testing tubal patency is difficulty conceiving and diagnosed infertility. Additionally, a gynecologist or reproductive specialist may recommend an ultrasound of the fallopian tubes or other methods of examination if the following symptoms or disorders are present:

Ectopic pregnancy;
Mild to intense lower abdominal pain that worsens with physical activity, sudden movements, or intercourse;
Vaginal discharge containing mucus and pus-like substances;
Chronic pelvic pain syndrome (persistent or intermittent pain in the sacral-lumbar area, iliac region, bladder projection area, perineum, frequent urination, reduced libido);
Painful menstruation (dysmenorrhea), heavy periods.

Methods of Diagnosing Tubal Patency in Dnipro Tubal patency cannot be assessed during a routine gynecological examination. If this condition is suspected, the following tests may be ordered:

Laboratory tests of gynecological smears (these analyses are supplementary methods that help diagnose infections accompanying inflammatory processes and impairing tubal patency);
Instrumental tests, including radiological, ultrasound, and laparoscopic procedures.

Radiological Tubal Patency Diagnosis In cases of suspected female infertility, radiological examination of the uterine cavity and tubes (hysterosalpingography, HSG) along with pelvic ultrasound is considered a first-line examination. The procedure is performed in the same position as a gynecological examination (in the chair):

A soft balloon catheter is inserted into the uterine cavity through a speculum;
The balloon is gently inflated with air;
A preliminary X-ray is taken;
A warm radiopaque substance is introduced, followed by a series of targeted X-rays of the uterus and tubes from different angles. HSG helps identify various pathologies of the uterus and tubes, including tubal obstruction, inflammatory processes, and adhesions. It is also performed after tubal cleansing procedures to evaluate the success of treatments aimed at restoring patency. Radiological examination is the best method for primary diagnostics, though it is not always sufficiently informative for differential diagnosis of various pathologies and evaluating the degree of obstruction. Therefore, to clarify the diagnosis, the doctor may recommend ultrasound of the fallopian tubes or diagnostic laparoscopy.

Ultrasound of the Fallopian Tubes Ultrasound examination of tubal patency (ultrasonographic hysterosalpingoscopy, UHSS or Echo-HSG) can be performed using either an abdominal or vaginal probe. The woman is placed in the gynecological chair, and a sterile ultrasound contrast medium, heated to 37°C, is introduced into the uterine cavity and tubes under ultrasound control. The ultrasound scanner visualizes the movement of the fluid in real-time. Free flow of the contrast medium into the fallopian tubes and from them into the abdominal cavity indicates normal tubal patency. If the fluid is retained and accumulates in the tube without exiting, tubal patency is impaired. If the obstruction is caused by mild adhesions, in 20-30% of cases, the fluid may clear the tubes due to gentle pressure.

Diagnostic Laparoscopy This is an invasive method used to examine tubal patency in complex cases. A small incision near the navel is made, through which an optical tube with a miniature camera and other instruments are introduced into the abdominal cavity. Tubal patency examination can be combined with therapeutic procedures such as adhesion removal, tuboplasty, or partial/full removal of the tubes.

How to Prepare for Tubal Patency Diagnosis Before any diagnostic procedure, general blood and urine tests, blood tests for infections, and smears from the genital tract are required. For diagnostic laparoscopy, a more detailed examination and consultation with an anesthesiologist are necessary, as it is considered a surgical intervention. Before the tubal patency test, pregnancy must be excluded. It is recommended to abstain from sexual intercourse or use reliable contraception from the end of menstruation until the procedure. Before HSG, the following preparations are necessary:

Abstain from douching and using vaginal medications for one week;
Abstain from sexual contact for 2 days;
Shave the pubic area, perform an enema, empty the bladder before the procedure;
Take a nonsteroidal anti-inflammatory drug an hour before the procedure. Depending on the situation, antispasmodics and antibiotics may also be prescribed. These medications should not be taken without a doctor's recommendation. For ultrasound of the fallopian tubes, it is recommended to take No-shpa (drotaverine) half an hour before the procedure to prevent spasms. Pain relievers are typically not needed. If the examination is performed using an abdominal probe, several glasses of water should be consumed beforehand.