Patient's question:
Recently, I had a hysterosalpingogram, and the results showed that both fallopian tubes are patent, consistent with X-ray signs of pelvic adhesions. The uterine cavity morphology and size were normal. (The doctor explained that the images showed mild adhesions, requiring laparoscopic surgery for treatment before attempting pregnancy. If it still doesn't work, artificial insemination can be considered.)Doctor's answer:
Analysis of the condition: Pelvic adhesions refer to the inflammatory changes that occur in pelvic tissues and organs, such as the uterus, fallopian tubes, and ovaries, due to bacterial or viral infections. Common conditions include uterine tubal inflammation and ovarian inflammation. These diseases can lead to tissue congestion, edema, and increased secretions. If medical attention is not sought in a timely manner, it may result in uterine adhesions, fallopian tube adhesions, or adhesions between the ovaries and fallopian tubes. These conditions are collectively referred to as pelvic adhesions.Recommendations: The application of laparoscopy and hysteroscopy in clinical practice allows for the intuitive, simple, and safe resolution of some more challenging gynecological conditions. These procedures not only help determine the extent and type of adhesions but also assess their firmness. For membranous adhesions or fibromuscular adhesions, they can be separated or removed using surgical scissors under hysteroscopy. However, for dense connective tissue-like adhesions, electrocoagulation separation under ultrasound guidance is required. Postoperatively, an intrauterine device should be placed to prevent re-adhesion, and a continuous regimen of estrogen and progesterone should be administered to promote endometrial growth. This helps restore menstruation in patients, and some may even be able to conceive again.