Dear Dr Mitchell,

Is it possible to unblock my blocked tubes, and what options are available to me?

Blocked tubes are most commonly due to pelvic inflammatory disease. Other causes of blocked tubes include scarring from previous surgery, endometriosis and appendicitis or ruptured appendix. Uterine fibroids can also cause the tubes to be blocked.

The Fallopian tubes can be blocked at various sites. The ends can be bound down from infection or adhesions resulting in pooling of secretions causing the tubes to form a long, dilated, fluid-filled structure. A Fallopian tube can be blocked at the insertion into the uterine cavity by fibroids and infection. In this situation the Fallopian tube might not be dilated but it will definitely prevent pregnancy from occurring.

An investigation should be done to determine the underlying cause of the blocked tubes. Any signs or symptoms suggestive of chlamydia or gonorrhoea should be investigated. Sexual contacts should also be investigated and treated. If this is not done the situation can worsen and you can end up with abscess (collection of pus) formation in the ovaries and Fallopian tubes. Tests should be done for other sexually transmitted infections.

An X-ray of the Fallopian tubes called a Hysterosalpingogram (HSG) can be done to determine if the tubes are blocked and the site of the blockage. This is important to determine if the Fallopian tubes can be repaired by doing an operation. A pelvic ultrasound can also pick up dilated blocked tubes but will not detect all forms of blocked tubes.

A laparoscopy can also be done to directly look at the Fallopian tubes and determine the extent of damage to the tubes and determine the underlying cause of the damage to the tubes. Endometriosis, pelvic infection, scarring from previous surgery and fibroids can be detected doing the laparoscopy. If the damage to the Fallopian tubes is minimal then attempts at repairing the tubes can be done at the same time. If the tubes cannot be repaired then the Fallopian tubes are sometimes removed to prepare the uterus for invitro-fertilisation (IVF) at a later date. Leaving severely damaged Fallopian tubes can interfere with successfully becoming pregnant using IVF.

Repairing blocked Fallopian tubes can also be done by doing a laparotomy. This is usually done by making a cut just above the pubic bone in the bikini area.

It is extremely important to determine the underlying cause of the blocked tubes so that you can treat these problems and then repair the Fallopian tubes if possible.

In some women there might be evidence of a blocked Fallopian tube and this fortunately becomes cleared after doing the HSG. The dye that is injected during the procedure can force out any mucus plug that might be causing a blockage and pregnancy occurs after the HSG, in spite of the report saying that the Fallopian tubes are blocked.

The risk of an ectopic pregnancy is significantly high if the tubes are blocked, and an early ultrasound should be done to ensure that the pregnancy is not lodged in the Fallopian tubes. This can rupture and cause massive blood loss if it is not diagnosed early.

The problem is that not all blocked tubes can be fixed and even when surgery is done the Fallopian tubes might still not function. The lining of the Fallopian tubes can be badly inflamed and damaged and so doing surgery might not be the way to go.

Consult your doctor who will advise your further.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.