Tubal Patency Test
Tubal Patency Test
Tubal Patency Test
Tubal patency tests are undertaken when the doctors suspect that there are blockages or pelvic
adhesions in the fallopian tubes. These tests include procedures like Gas Insufflation,
Hysterosalpingography (H.S.G.), Laparoscopy, etc.
CAUSES OF TUBAL OBSTRUCTION
TYPES
there are the various types of tubal patency tests
1. Gas Insufflation
This is the oldest method of assessing tubal patency and is often referred to as "blowing the
tubes". It is a simple test to carry out and does not require a general anaesthetic.
procedure
An instrument is inserted into the canal of the cervix and carbon dioxide gas is "blown" into the
cavity of the uterus
The machine controlling the flow of carbon dioxide also records the pressure of the gas as it
builds up in the uterus.
There will be an increase in pressure of the gas within the uterus if the tubes are blocked.
If the tubes are open, the initial rise in pressure is followed by a sudden reduction as the gas
escapes along the tubes and into the abdominal cavity.
However, the results of this test can be difficult to interpret and the test can be unreliable.
Furthermore, if the tubes are blocked, the test gives no information about the location or nature
of the obstruction.
The inaccuracy of the test has led it to be largely superseded by the following two procedures.
2. Hysterosalpingography (H.S.G.)
procedure
An instrument is gently passed into the canal of the cervix and a special radio-opaque dye is
carefully injected into the cavity of the uterus.
The test is performed in the X-ray department and normally does not require any form of
general anaesthetic.
It can, however, cause you to experience a moderate amount of discomfort rather like period
pains.
The dye shows up on an X-ray screen and the doctor is able to see the fluid filling the uterus and
then passing along both tubes to enter the cavity of the abdomen.
If the dye fails to enter the tubes this may indicate an obstruction at the junction between the
uterus and the tubes or simply a temporary spasm of the tubes at this site.
Sometimes the dye can be seen to enter the tubes, which then become distended owing to
an obstruction at their outer ends.
The H.S.G. can pinpoint the site of any tubal obstruction and can also show the presence of any
irregularity in the shape of the cavity of the uterus. However, this test cannot identify the
existence of pelvic adhesions, which may be enveloping the ovaries and preventing eggs from
having access to the tubes.
3. Laparoscopy
This is a much more complex procedure than the previous two tests. It is performed under a
general anaesthesia and will require your admission to hospital.
procedure
The abdominal cavity is then distended with carbon dioxide gas in order to create more space to
accurately view the pelvic organs.
A slim telescope called a laparoscope is then inserted into the abdominal cavity and the uterus,
tubes and ovaries are thoroughly inspected.
The presence of adhesions either around the tubes or tethering the ovaries can be easily detected,
and their significance assessed
. Other pelvic problems such as endometriosis and fibroids will also be revealed.
Tubal patency is tested by injecting methylene blue dye into the uterus through the cervix. If the
tubes are healthy, the dye can be seen passing along them and escaping through the outer
openings of the tubes.
advantage
The great advantage of laparoscopy over H.S.G. is that it allows the surgeon to have a direct
view of the pelvic organs and thereby permits a much more accurate assessment of tubal patency
and any tubal or ovarian problems. The need for further surgery can be determined without
having to resort to major abdominal surgery at that time. The majority of patients are able to
leave hospital the following day. The tiny operation scar is eventually virtually invisible.