Proximal Tubal Obstruction

In: Reproductive Surgery · 2022 · pp. 83–89 · doi:10.1007/978-3-031-05240-8_7 · W4294017888
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This review covers the causes, diagnosis, treatment, and success rates of proximal tubal blockage, commonly resulting from inflammation or surgery, which often leads to IVF recommendations.

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This chapter reviews proximal tubal obstruction, focusing on its causes (including inflammatory processes such as salpingitis isthmica nodosa, endometriosis, and surgical trauma), methods of diagnosis, and treatment outcomes, particularly in women evaluated for infertility. It discusses tubal disease as a common indication for IVF, notes that many patients do not proceed, and summarizes that fallopian tube cannulation (via hysteroscopy/laparoscopy or under fluoroscopy at HSG) achieves patency in about 70–80% of cases despite low pregnancy rates. A key caveat emphasized is the discrepancy between restoration of tubal patency and subsequent pregnancy outcomes, limiting the effectiveness of cannulation as a standalone solution. Relevance to endometriosis: the chapter explicitly lists endometriosis as a cause of proximal tubal obstruction and places it within the broader review of etiologies and management for proximal tubal blockage.

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Abstract

Proximal tubal blockage is most commonly caused by an inflammatory process such as salpingitis isthmica nodosa, endometriosis, and surgical trauma such as post-myomectomy. Tubal disease is one of the most common diagnoses for IVF and upon diagnosis, IVF is most often recommended. However, many women decide not to proceed with IVF due to the cost, or religious reasons. Fallopian tube cannulation either with hysteroscopy/laparoscopy or under fluoroscopy at the time of HSG can be performed with patency rates of 70–80 percent but the pregnancy rates remain low. This chapter reviews the causes of proximal tubal blockage, diagnosis, treatment, and success rates. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Proximal Tubal Obstruction. In: Lindheim, S.R., Petrozza, J.C. (eds) Reproductive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-05240-8_7 Download citation DOI: https://doi.org/10.1007/978-3-031-05240-8_7 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-05239-2 Online ISBN: 978-3-031-05240-8 eBook Packages: MedicineMedicine (R0)

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