By Abayomi Ajayi

Tubal disease, also  one of the many causes of female infertility, is a disorder in which the fallopian tubes are blocked or damaged. The fallopian tube is an active, muscular organ that retrieves the egg from the ovary and coaxes it toward the oncoming sperm.

If adhesions restrict the tube’s mobility or if infection has stripped the tiny cilia from the tubal lining the tube cannot perform its vital job.

A fallopian tube blockage typically prevents successful passage of the egg to the sperm, or the fertilized egg to the uterus. Various tests help determine if the tubes are open (patent), are free from adhesions so they can move and if the inner lining of tiny hairs (cilia) is intact.

A review of medical history and complete pelvic examination to diagnose a tubal disorder is often necessary. In practice, we know that scar tissue, infections and tubal ligation are often causes of tubal disease. Scar tissue resulting from endometriosis or abdominal or gynaecological surgery, such as bowel surgery, cesarean section or a ruptured appendix, can block an egg from entering or traveling down the fallopian tube to meet the sperm, preventing fertilization. Infections, including chlamydia, can damage the cilia, the tiny hairs lining the fallopian tubes that help transport the egg, often preventing the sperm and egg from meeting.

Many women who have undergone tubal ligation, had their “tubes tied”, decide they want to have a baby at some point after the procedure. These patients most often undergo in vitro fertilisation to bypass the blockage. In some rare cases, surgery can be done to reattach tubes after ligation.

Evaluation of tubal performance is commonly by tubal x-ray, an ultrasound test, laparoscopy  and tuboscopy (telescopic look inside the tubes). Surgery can be used to try to correct this common cause of infertility, but the specific type of surgery depends on the location and extent of the fallopian tube blockage. Some tubal procedures can be done using microsurgical techniques, either during open abdominal surgery or using laparoscopy through a small incision.

There are a number of treatment options available to overcome infertility caused by tubal disease. A specialist physician needs to go over the options with the patient so as to determine the treatment that will be most effective and lead to the desired outcome of having a baby.

After open abdominal surgery, there usually is a 2- to 3-day hospital stay. Antibiotics may be given to prevent infection. A woman usually can return to work in 4 to 6 weeks, depending on the extent of surgery, the nature of her work, and her overall health and stamina. A woman’s return to daily activities can take a few days to a couple of weeks, depending on the type of procedure. Fallopian tube surgery may be done if you are young and have no other fertility-related problems.

The success of a fallopian tube procedure depends in part on the location and extent of the blockage, as well as the presence or absence of other fertility problems. From 20-30 percent of women with a blockage near the end of the fallopian tube have had successful pregnancies after tubal surgery.

From 20-30 percent of women with a blockage near the end of the fallopian tube have had successful pregnancies after tubal surgery. The amount of fallopian tube that remains after surgery is critical to the function of the tube. A point to note is that some fallopian tube problems can be treated with more than one type of surgery or procedure.