Fallopian Tubes

Fallopian Tube Repair

The tubal reversal doctors at Chapel Hill Tubal Reversal Center are specialists in fallopian tube repair. Although most of patients come to Chapel Hill Tubal Reversal Center for tubal ligation reversal, others come for fallopian tube repair after a tubal infection or pelvic inflammatory disease (PID), ectopic pregnancy, or previous surgery involving the fallopian tubes.

Fallopian Tube Anatomy

The fallopian tube begins within the muscular wall of the uterus (interstitial segment), leads away from the uterine wall (isthmic segment), becomes wider (ampulla), extends to the widest area near the end of the tube (infundibulum), and ends next to the ovary (fimbrial segment).

The fallopian tube has several important functions that include:

• Capturing the egg at ovulation
• Providing the proper environment for fertilization
• Transporting the fertilized egg to the uterine cavity

When fallopian tubes have become damaged, pregnancy difficult and sometimes impossible to achieve.

Fallopian Tube Disease

When a fallopian tube is damaged and completely closed, sperm cannot reach an egg to fertilize it, and the egg cannot reach the uterine cavity. Common causes of fallopian tube damage are:

• Pelvic inflammatory disease (PID)
• Other abdominal infections
• Ectopic pregnancy
• Prior pelvic surgery

Diagnosing Fallopian Tube Disorders

The possibility of fallopian tube damage should be suspected when a woman is either unable to become pregnant or has a history of multiple ectopic pregnancies. The diagnosis of a damaged fallopian tube usually is made from an x-ray procedure called a hysterosalpingogram (HSG). During an HSG, a radio-opaque dye is placed into the cavity of the uterus and pictures are taken as the dye flows into the fallopian tube. If the dye does not travel freely from the uterine cavity and through the fallopian tube into the abdominal cavity, then fallopian tube damage is suspected.

Fallopian Tube Repair

Fallopian tube damage due to infection of the tube may result in a swollen, club-shaped tube called a hydrosalpinx. In this situation, the fimbrial end of the tube is closed by scar tissue. This is easily diagnosed by a HSG when the dye is seen to fill the fallopian tube but becomes trapped within it at its swollen fimbrial end. This is the most common type of tubal disease that results in patients seeking fallopian tube repair.

Repairing Hydrosalpinx

A hydrosalpinx can be repaired by the technique of microsurgical salpingostomy. In this procedure, the fimbrial end of the fallopian tube is opened and folded back where it is sutured in place to keep the tube open. Any scar tissue responsible for closing the end of the tube is removed. Pregnancy success rates after microsurgical salpingostomy are approximately 40%. There is an increased risk of ectopic pregnancy after repair of a hydrosalpinx, particularly if the internal lining of the tube has been damaged extensively. It is the internal lining, rich in cilia, that help move the egg down the tube to arrive in the uterine cavity.

Fallopian Tube Repair at Chapel Hill Tubal Reversal Center

The tubal reversal doctors at Chapel Hill Tubal Reversal Center, Dr. Gary Berger and Dr. Charles Monteith, are reproductive surgeons who are specialists in tubal ligation reversal and fallopian tube repair. They perform more than 800 tubal reparative surgeries each year for women from throughout the United States and around the world. Their vast experience in repairing fallopian tubes allows women with fallopian tube damage to become pregnant naturally as opposed to the more expensive and complicated treatment of in vitro fertilization.

Challenging Tubal Ligation Reversal: Uchida Tubal Ligation

Tubal Reversal Experts

The tubal ligation reversal experts of Chapel Hill Tubal Reversal Center are experienced at sterilization reversal. Many women who have had their ‘tubes tied’ will come to our center to have their ‘tubes untied’. Unfortunately, a ligation reversal is not as easy as ‘untying’ the tubes- we wish the process was that simple.

We employ a microsurgical approach to repair and reattach the ends of the tubes. This process is called tubotubal anastamosis, and provides a patient with an excellent chance of becoming pregnant naturally. We specialize in ligation reversal and in reversal of difficult tubal ligation procedures.We would like to present the story of one of our patients who had an atypical sterilization procedure.

Reversal of an Unusual Sterilization Procedure

The patient’s name is Ofralinda. She and her husband, Juan, came to us from Texas. Ofralinda is 35 and she works as an OSHA compliance officer. Her husband is in construction. Ofralinda desired a tubal ligation reversal in order to have more children. She had a rare and atypical sterilization procedure termed the Uchida procedure.

Uchida Sterilization Procedure

A Japanese physician, Dr. Uchida, first described this method of sterilization in 1961. This method involves removing a large segment of the fallopian tube and suturing (sewing) the cut end of the fallopian tube into the wall of the uterus. Dr. Uchida first published information about his method of sterilization after having performed over 50,000 procedures without any pregnancy failures. This is an effective but also complicated method of surgical sterilization. Most modern physicians have never performed or seen a Uchida sterilization. We have seen several patients who have presented with a Uchida sterilization procedure and we have had success with reversal of this method.

Uchida Sterilization Reversal

Ofralinda had a 60-minute outpatient tubal ligation reversal. Her surgery went well. We found her tubes to be short (due to the large amount of tube removed with her initial Uchida sterilization) but otherwise healthy. We were able to successfully repair both of her fallopian tubes. She has since been discharged back to her home and we wish her well. We would like to hear a report of a successful pregnancy from her within the year.

Sterilization Reversal at Chapel Hill Tubal Reversal Center

We specialize in tubal ligation reversal. Our tubal ligation reversal specialists perform over 800 reversal procedures every year on women from across the world. We regularly have patients from as far away as Hawaii, Alaska, and the Caribbean. Occasionally, we will have patients from Australia, Asia, and Europe.

Most tubal ligation procedures are reversible. The pregnancy rates after reversal are generally higher than after in vitro fertilization (IVF) and we specialize in difficult tubal reversal procedures.

More Information on Fallopian Tube Repair