Uterine and Fallopian Tube Hydrotubation

Hysterosalpingography is a procedure that women undergo to check if there is any problem with their fallopian tubes. Generally speaking, large hospitals can perform this operation, but for some women, hysterosalpingography cannot be performed. For example, some female friends who have irregular menstruation or have tumors in the pelvic cavity cannot undergo hysterosalpingography.

Surgical procedures

(1) Empty the bladder, assume lithotomy position, disinfect the vulva and vagina, and lay a sterile surgical towel.

(2) Bimanual examination is used to understand the size, position, texture, mobility, shape of the uterus and its relationship with surrounding organs, as well as to determine if there are any abnormalities in the bilateral adnexa.

(3) Place the speculum, expose the cervix, disinfect the vagina and cervix, clamp the anterior lip of the cervix with a cervical clamp, and pull it outward to make the uterus horizontal.

(4) Use a uterine probe to gently probe the uterine fundus along the direction of the uterus, measure its depth and confirm its curvature and size.

(5) Check that the liquid flow device is intact and leak-free.

(6) Insert the uterine catheter into the cervical canal in the direction of the probe detection and fix it at the pre-selected depth. Clamp the anterior lip of the cervix with a tissue forceps to pull the cervix outward, while pushing the conical head of the catheter inward so that the two fit tightly together. Use a syringe filled with 20 ml of solution to slowly inject the liquid. If 20 ml of liquid is injected smoothly without resistance, there is no leakage outside the cervix, and the patient has no obvious discomfort, it means that the fallopian tube is unobstructed.

(7) If resistance is encountered, apply a little pressure. The patient will have a little abdominal discomfort and the injection can be successfully completed. There is no leakage from the external cervical opening, indicating that the original adhesions have been separated or the spasm has been relieved.

(8) When the fluid is flowing, the sound of fluid coming out from the fimbria of the fallopian tube can be heard by listening with a stethoscope on both sides of the lower abdomen.

(9) When you feel great resistance, fluid overflows from the external cervical opening, and your abdomen becomes bloated and unbearable, it is usually because the fallopian tubes are completely blocked.

Hydrotubation is the process of injecting methylene blue solution or saline into the uterine cavity from the cervix. Then it flows into the fallopian tube from the uterine cavity. The resistance when the medicine is injected and the reflux of the liquid are used to determine whether the fallopian tube is unobstructed. Through a certain pressure of the liquid, the obstructed fallopian tube is restored to patency. However, since hydrotubation involves injecting liquid into the uterine cavity using a catheter, the volume and surface area of ​​the uterine cavity are much larger than the cross-sectional area of ​​the catheter and fallopian tube cavity. According to the principles of fluid dynamics, the pressure is equal to the pressure divided by the force-bearing area. Therefore, the pressure of the fluid injected into the fallopian tube is very limited. The therapeutic effect is very limited. Currently, in hospitals with the necessary conditions, this examination method has been completely replaced by hysterosalpingography.