Patient's question:
Hello, how does the doctor perform the fallopian tube patency test? What are the things checked in the fallopian tube patency test?Doctor's answer:
Okay, here is the translation, following your instructions:I. Hysterosalpingography (HSG)
Gas (carbon dioxide or oxygen, air use is cautiously recommended) is injected into the uterine cavity via a catheter. The diagnosis of fallopian tube blockage is determined based on the injection pressure, auscultation of the lower abdomen, the patient's sensation, and the observation of free gas under the axilla on abdominal fluoroscopy. The diagnostic accuracy of this method is only 45.0%-50.0%, and it carries the potential risk of air embolism. It is not suitable as a method for assessing fallopian tube patency and has been gradually replaced by other methods.
II. Tubal Lavage Test
Liquid is injected into the uterine cavity via a catheter. The presence and degree of resistance during injection, the presence or absence of reflux, the volume of liquid injected, and the patient's sensation are used to determine if the fallopian tubes are blocked. Although this method is inexpensive, it causes relatively severe damage to the fallopian tubes and has been abandoned in clinical practice.
III. Laparoscopic Tubal Lavage Technique
Under direct vision, the tubal ostia are identified, and the appearance and surrounding conditions of the fallopian tubes are carefully examined. The tubal catheter is slowly inserted from the port of entry into the interstitial part of one fallopian tube. First, a mixture of methylene blue solution (0.5 ml methylene blue mixed with 30 ml 2% metronidazole) is slowly pushed in. The absence or presence of reflux, the amount of reflux, is observed. Then, 2% metronidazole is pushed in fractionally under increasing pressure, from 30 to 70 ml. During the injection, the degree of resistance is estimated, and the presence or absence of swirling echoes of flowing liquid within the uterine cavity, as well as the flow rate of liquid leakage, are observed to determine if the fallopian tubes are blocked.