TUBAL ASSESSMENT

AND TUBAL SURGERY

Dr. Aprian Ilhami
Embryologi of Fallopian Tubes

Embryos develop a urogenital ridge that forms at their tail end and eventually forms the
basis for the urinary system and reproductive tracts.

Either side and to the front of this tract, around the sixth week develops a duct called the
paramesonephric duct, also called the Müllerian duct

A second duct, the mesonephric duct, develops adjacent to this. Both ducts become longer
over the next two weeks

The paramesonephric ducts around the eighth week cross to meet in the midline and fuse. In
females, the paramesonephric duct remains, and eventually forms the female reproductive
tract
Embryologi of Fallopian Tubes
ANATOMY & PHISIOLOGY
ANATOMY & PHISIOLOGY
 Part of Fallopian Tube
ANATOMY & PHISIOLOGY
1.Intramural (interstitial) part,
which is located within the
myometrium of the uterus, is 1 cm
long and 0.7 mm wide.
2. The isthmus, which is rounded,
muscular part of the fallopian tube. It
is 3 cm long and between 1 and 5 mm
wide.
3. The ampulla, which is longest part
of the tube. It has a diameter of 1 cm
at its widest point and is 5 cm long. It
has a thin wall, a folded luminal
surface and fertilisation usually takes
place within its lumen.
4. The infundibulum, which is the
distal end of the tube. It is funnel
shaped and opens into the peritoneal
cavity at the abdominal ostium
ANATOMY & PHISIOLOGY

Fallopian Tube
The main function of the fallopian tubes are
facilitate the transportation of the sperm to the egg
and afterward.

Facilitating the passage of a fertilized egg into the

uterus through a peristaltic and ciliary movement.

Secreting mucus, thereby aiding the transportation

of both sperm and egg.
 Non Surgical Method
Evaluating Fallopian Tubes
1.HSG (Hysterosalpingography)
2. SIS (Saline Infusion
Hysterosalpingoraphy )
3. HyCoSy ( Hysterosalpingo-contrast-
sonography )

detect small visible of tubal

abnormality or tubal
patency not all tubal defect
and damage can be
evaluated from non surgical
method
Evaluating Fallopian Tubes Surgical Method

Laparoscopy
Laparoscopy can also identify subtle tubal factors
such as hydrosalpinx , fimbrial phimosis or
peritubular adhesions ,endometriosis that may
escape detection with less-invasive methods.

Salpyngoscopy
Clearly demonstrate the presence or absence of
anatomical distortions, especially adhesions
between and destruction of mucosal folds on a
microendoscopic, i.e. mucosal level.

Falloposcopy
microendoscopy of the oviductal lumen from
the uterotubal ostium to the fimbriae by a
transcervical approach
 Evaluating Fallopian Tubes
Tubal disease includes tubal obstruction,
narrowing, dilatation, as well as conditions that
alter tubal function due to changes in the tubal
mucosal lining, muscular wall or any pathology
present external to the tube
A good prognosis is associated with patients who have
no more than limited filmy adnexal adhesions,mildly
dilated tubes (<3 cm) with thin and pliable walls,and
a lush endosalpinx with preservation of the mucosal
folds
Severe features ( irreversible condition)
Tubal scarring, Rigidity, Fibrosis,
Stenoocclusions, Dilatations, Hydrosalpinx,
Peritubal and Pelvic Adhesions
American Fertility Society. The American Fertility Society classifications ofadnexal adhesions, distal tubal occlusion, tubal occlusion secondary to
tuballigation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions.Fertil Steril 1988;49:944–55.
Surgery in Fallopian Tubes

Salpyngostomy for conservative mild damage

Surgery in Fallopian Tubes
Salpyngectomy

Salpyngectomy for surgical removal of fallopian

tube •Endometriosis
•Tubal adhesions
•Scarring or blockage
•Ectopic pregnancy
•Blocked fallopian tube
•Ruptured fallopian tube
•Hydrosalpinx
•Fallopian tube cancer
TERIMA KASIH
 Title Lorem Ipsum

LOREM IPSUM DOLOR SIT AMET, NUNC VIVERRA IMPERDIET PELLENTESQUE HABITANT
CONSECTETUER ADIPISCING ENIM. FUSCE EST. VIVAMUS A MORBI TRISTIQUE SENECTUS ET
ELIT. TELLUS. NETUS.