Proximal Tubal Blockage

Definition - What does Proximal Tubal Blockage mean?

A proximal tubal blockage is the blockage of the tube at its proximal portion, which is the part connected to the ends of the uterus on either side. Proximal blockage accounts for about 10%–20% of women diagnosed with infertility.

FertilitySmarts explains Proximal Tubal Blockage

Tubal blockage can involve the proximal, mid, or distal portion. Proximal tubal blockage can be due to:

  • Chronic salpingitis, a long-standing inflammation of the fallopian tubes
  • Endometriosis, the growth of the inner uterine lining outside its normal location
  • Previous surgery
  • Mucus plugs
  • Ectopic pregnancy
  • Sexually transmitted disease typically chlamydia and gonorrhea

The primary symptom of proximal tubal blockage is infertility. Many women are unaware that their fallopian tubes are damaged until they have seen a doctor for infertility. In some, infertility is accompanied by symptoms of pelvic inflammatory disease, such as constant lower abdominal pain.

In women presenting with infertility, an X-ray procedure called hysterosalpingography (HSG) may help determine proximal blockage by preventing the entry of the dye into the proximal portion of either tube. However, if the dye can’t be seen flowing out of the proximal portion, it doesn’t always necessarily mean that the tube is blocked. A build-up of mucous plug in the proximal region can occlude the fallopian tube and keep the dye from entering, giving a false impression that the proximal tube is blocked.

Additional testing with laparoscopy can help clarify whether or not the tube is blocked as well as reveal the presence of any other problem such as scarring.

There are various ways to repair a tube blocked at the proximal end. The two major ones include:

  • Tubal cannulation, in which the doctor inserts a tube called catheter with a balloon attached to it into the fallopian tube to unblock it. Tubal cannulation is only done if an imaging test shows a proximal blockage in one or both fallopian tubes.
  • Reconstructive tubal microsurgery may also be carried out to unblock the tube, such as after failure of the tubal cannulation procedure. The goal of this fertility-promoting surgery is to restore the anatomic and functional integrity of the tube.

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