Ultrasound of the fallopian tubes - the fallopian tubes are not visualized

I needed to undergo an ultrasound, and now I’m sitting reading the results. Everything is more or less clear, but one thing worries me. The ultrasound report says that the fallopian tubes are not visualized. What does this mean, who knows? Is this bad or normal? I didn’t go there about this issue, and the doctor didn’t say anything. And I read it after I had already left. It became alarming. I am 22 years old and have plans to have children.

Visualization

Normally, the fallopian tubes are not visualized during an ultrasound examination. This means that they are not visible. They can be seen on an ultrasound if there is an accumulation of fluid in the lumen of the fallopian tubes. And this is a sign of an inflammatory process, that is, pathology.

In addition to inflammatory processes in the fallopian tubes, an adhesive process can also develop. In this case, if the lumen of the tube is completely closed, a sactosalpinx and hydrosalpinx are formed - a cavity filled with liquid. The nature of the fluid can be determined through further examination, and an ultrasound will determine the presence of an inflammatory process and its location (right and/or left tube).

When there is cause for concern

Due to the progression of the inflammatory process, activation of adhesive processes in the area of the fallopian tubes may be observed. This is accompanied by nagging pain, menstrual irregularities, and difficulties in conceiving a child. For any of the described or any other symptoms, it is recommended to refrain from self-medication and seek advice from an experienced gynecologist. The sooner specialists identify the cause of the disorder and direct efforts to eliminate it, the more favorable the prognosis for the woman.

Methodology

The ultrasound examination technique is quite simple and absolutely painless. In addition, ultrasound, contrary to popular myth, is a safe technique, which is why it is used for diagnosis during pregnancy.

Indications for ultrasound:

During pregnancy, ultrasound is performed at the very beginning, when there is a delay in menstruation. Also, the study is carried out as planned at the beginning and each trimester, and in the presence of pathologies it can be carried out several times more often.

With a conventional ultrasound, if there is no development of pathological processes or accumulation of fluid in the pelvic cavity, then the fallopian tubes are not located, that is, they are not visible. There are special techniques for determining the patency of the fallopian tubes. How to check the fallopian tubes for patency and why is this necessary?

Sometimes, under the influence of many reasons, among which the factor of inflammatory processes prevails, the adhesive process is activated in the fallopian tubes. Adhesions connect the walls of the fallopian tubes to each other, blocking, significantly or completely, the lumen in the tubes.

As a result, the patency of the fallopian tubes is disrupted. This situation manifests itself as nagging pain in the lower abdomen from the affected tube, menstrual irregularities, and infertility develops.

If the lumen of the fallopian tube is not completely closed, there is a risk of ectopic pregnancy. The fertilized egg cannot penetrate the uterine cavity, where it should attach to the endometrium and develop further, but remains in the fallopian tube and begins to grow

When the egg reaches a certain size, signs will appear:

pain from the affected organ,
delayed menstruation (or scanty spotting),
nausea,
headache.

In the future, the fallopian tube may rupture and peritonitis will develop. This is a life-threatening situation.

Therefore, representatives of the fair sex who are planning a pregnancy or have problems with the reproductive system are recommended to undergo a procedure for checking the patency of the fallopian tubes. There are two ways to do this.

Hydrosonography

The procedure is carried out under ultrasound control. The patient is placed on a gynecological chair, legs bent at the knees. A speculum is inserted into the vagina. Then the cervix and vagina are treated with antiseptics. A catheter is inserted through the cervical canal of the cervix into the uterine cavity.

The next step will be the introduction of saline solution into the uterine cavity. The fluid will first enter the uterus and then pass through the fallopian tubes. It is the process of fluid passing through the pipes that is monitored using ultrasound. The procedure itself lasts approximately 25-30 minutes, ultrasound control can be carried out transabdominally and transvaginally.

Before the procedure, the specialist prescribes an examination:

The examination is prescribed from 7 to 21 days of the menstrual cycle; the most effective period is considered to be the period from 8 to 12 days of the cycle (before ovulation). At this moment, the lumen of the cervical canal opens, which facilitates the insertion of the catheter. However, the individual characteristics of each woman’s cycle should be taken into account.

Directly on the day of the study, it is recommended to take an antispasmodic agent (Spazmalgon, No-shpa). You need to have a sanitary pad with you, as spotting may occur. The consequences of the procedure may be accompanied by minor nagging pain in the lower abdomen and the presence of discharge.

Together with determining the patency of the fallopian tubes, the condition of the uterus (fibroids, polyps, endometritis, etc.) can be determined. The procedure does not require a long hospital stay or anesthesia.

Why and how to do an ultrasound of the fallopian tubes

Inspection of the projection area of the fallopian tubes is carried out during each ultrasound examination of the pelvic organs in women. Pathologically unchanged fallopian tubes are not visualized on ultrasound.

However, with
a transvaginal examination, in a small percentage of patients, doctors are able to remove the organ against the background of peritoneal fluid that has leaked during ovulation.
Thus, if the study protocol states that the fallopian tubes are not detected on ultrasound, this means that they were not subject to pathological changes. Indications for echohysterosalpingography (EchoGSS), or hydrosonography (ultrasound examination of the uterine appendages):

menstrual irregularities (irregularity, painful menstruation, changes in their duration);
frequent inflammatory processes of the internal genital organs;
suspected infertility (unsuccessful attempts to conceive a child within 12 months);
pain in the lower lateral abdomen, suprapubic region;
a history of sexually transmitted diseases;
preparation for in vitro (artificial) fertilization.

If a transabdominal ultrasound , then the woman should exclude foods that increase gas formation in the intestines 2-3 before the procedure. On the day of the study, 1-1.5 hours before the procedure, you need to drink 800-1000 ml of liquid to fill the bladder. With the transvaginal technique, the bladder must be empty, that is, you need to urinate before the examination.

How is hydrosonography performed:

The woman takes a comfortable position in a special gynecological chair.
The doctor inserts a thin catheter into the uterine cavity through the cervix. After which, a sterile saline solution at a temperature of 37 degrees (or Echovist) is supplied to the organ.
Under ultrasound control, the doctor monitors the process of filling the uterus and fallopian tubes with the solution.
At the end of the study, the sensor is removed from the vagina, and the catheter is removed from the uterus.

With a regular scan, without the use of a contrast agent, this organ is not described in any way - this means that the fallopian tubes are not visualized. According to official statistics, complete or partial organ obstruction occurs in 42-80% of infertile women.

Anatomical and physiological features of the organ

The uterine, or fallopian, tubes are considered a hollow and somewhat elongated paired organ, which is an important part of the female reproductive system. They are located almost horizontally and start from the fundus of the uterus on both sides.

The main functions of the fallopian tubes:

transportation of eggs and sperm;
creating favorable conditions for fertilization, development of the zygote and its movement into the uterine cavity.

Normally, each tube begins with the uterine (or interstitial) section, which is enclosed in the thickness of the myometrium and has a length of about 15-30 mm. Outside the uterus, the organ passes into the isthmus (isthmic section) - a thin horizontal canal in the leaves of the broad ligament, having a length of 27-40 mm. The isthmus is followed by the ampulla. It occupies about 50% of the entire length of the pipe and ends in a kind of funnel, on which there are narrow and long villi - fimbriae. The latter capture the egg released into the pelvic cavity as a result of ovulation and transfer it to the tube.

In women of reproductive age, the average length of the fallopian tube ranges from 100-120 mm, and its thickness is 5 mm. At the same time, according to statistics, the left tube is slightly shorter than the right one.

Normal ultrasound picture

What does a normal ultrasound picture look like in healthy women?

Normal uterus

When assessing the condition of the uterus with ultrasound, you can determine:

Position of the uterus. Normally, the uterus is either deviated towards the bladder, that is, anteriorly (this position of the uterus is called anteflexio), or deviated towards the rectum, that is, posteriorly, (retroflexio).
Dimensions of the uterus (longitudinal, anteroposterior and transverse). The average dimensions of a normal uterus are from 4.0 to 6.0 cm in length, anterior-posterior from 2.7 to 4.9 mm. The dimensions of the uterine body vary depending on the woman’s age, constitution and obstetric-gynecological history.
The condition of the endometrium (its thickness varies depending on the day of the menstrual cycle). Immediately after the end of menstruation, the endometrium is visualized in the form of a strip 1-2 mm thick. In the second phase of the cycle, the thickness of the endometrium (M-ECHO) can range from 10 to 14 mm on average.
Condition of the myometrium. Normally, the myometrium should be homogeneous and not have pathological formations in its structure (fibroids, adenomyosis, etc.)

Normal ovaries

When assessing the condition of the ovaries using ultrasound, it is determined:

Position of the ovaries. Normally located on the sides of the uterus, most often asymmetrically, at a short distance from the corners of the uterus. The shape of the ovaries is usually oval, while the right and left ovaries are not at all identical to each other.
Dimensions of the ovaries (longitudinal, anteroposterior and transverse). The average size of normal ovaries in length is from 2.4 to 4.0 cm, anterior-posterior from 1.5 to 2.5 mm.
Structure of the ovaries. Normally, the ovaries consist of a capsule and follicles of varying degrees of maturity (in the first phase of the cycle). In the second phase of the cycle, as a rule, the corpus luteum is visualized - a sign of ovulation. The number of follicles may be different on the left and right. The maturing follicle is detected already in the first phase of the cycle and reaches its maximum size by ovulation, on average about 20 mm.

The contents of the dominant follicle are homogeneous because it contains follicular fluid and the capsule is thin. After ovulation, at the site of the dominant follicle, a corpus luteum is formed, which, as a rule, has a mesh echostructure (it contains adipose tissue) and also a thin capsule - 1-2 mm. Most often, the shape of this formation is oval or irregularly shaped.

In postmenopause, the ovaries are normally either not visualized or are located in the form of fibrous cords.

Normal fallopian tubes

Normally, the fallopian tubes are not visible during ultrasound examination.

Short term intrauterine pregnancy

During pregnancy, only the fertilized egg is visualized in the uterine cavity in the early stages; later, an embryo appears. The size of the fertilized egg and embryo must correspond to the period of pregnancy according to menstruation.

It is also mandatory to evaluate the fetal heartbeat, which, as a rule, appears after 10-14 days of delayed menstruation.

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During pregnancy, the corpus luteum of pregnancy should be visualized in one of the ovaries, which controls the development of this pregnancy and ensures the vital activity of the fetus in the early stages (before the formation of the placenta).

Consultation with MD, professor of obstetrician-gynecologist
Consultation with PhD, obstetrician-gynecologist
Expert ultrasound of the pelvic organs with Doppler ultrasound
Expert ultrasound of all organs
Consultations with relevant specialists based on the survey results obtained

Source: www.ya-zdorova.ru

Why fallopian tubes are not visualized on ultrasound

Normally, these structures are so thin and small that the resolution of most devices simply does not allow them to be examined using ultrasound. In addition, the pipes constantly make floating movements.

With the transvaginal technique , provided that a sufficient amount of fluid accumulates in the pelvis, it is sometimes possible to “catch” this organ. Normal pipes have a uniform structure; the muscle layer and lumen are not determined. In some cases, the doctor may see the ampullary segment with fimbriae.

That is why, to assess the condition of the “appendages” of the uterus, hydrotubation, or hysterosalpingoscopy, is performed.

Causes of fallopian tube obstruction

In rare cases, the causes of adhesions in the tubes may be cesarean section, ruptures during natural delivery, intrauterine device

Surgical interventions, abortions, curettage.
Diagnostic procedures as an additional source of infections (hysteroscopy, hysterosalpingography).
STIs (sexually transmitted infections), such as gonorrhea, chlamydia.
Inflammatory processes, for example, salpingitis, adnexitis, salpingoophoritis.
Birth defects.
Endometriosis.

Causes of disorders in the reproductive system

In a significant number of cases, pregnancy may not occur due to lack of patency of the fallopian tubes. Causes of pathology:

anomalies in the development of internal organs of the reproductive system ( bicornuate, rudimentary uterus , etc.);
inflammatory processes on the part of the uterine appendages ( oophoritis, salpingo-oophoritis, adnexitis );
adhesive disease in the pelvic area as a result of peritonitis after surgery;
widespread endometritis (inflammation of the inner lining of the uterus) as a complication of abortion;
interrupted or surgically terminated ectopic pregnancy.

Are fallopian tubes visible on a pelvic ultrasound: normal – no; their full examination is possible provided that a contrast agent is injected into the uterus. This study is called hysterosalpingoscopy, it is carried out according to strict indications and in the absence of pregnancy, acute inflammation or tumors of the genital organs, or uterine bleeding. The procedure is performed by gynecologists using an ultrasound machine, a special catheter and a contrast agent.

Why do ultrasounds be done?

Ultrasound is a simple, painless technique that is performed according to indications: for complaints of pain in the lower abdomen, menstrual irregularities, heavy periods, intermenstrual bleeding, to control ovulation, as well as timely detection of tumors. The procedure is also prescribed to patients with a history of sexually transmitted diseases in preparation for in vitro fertilization. During pregnancy, the procedure is performed every trimester to monitor the growth and development of the fetus. Conventional ultrasound does not visualize the fallopian tubes and other diagnostic techniques are used to determine the patency of organs.

Inflammation of the fallopian tubes (lecture at Diagnostic)

Article under development. Unchanged fallopian tubes are not visible with TAUS, except for the accumulation of a large amount of fluid in the pelvic cavity. The fallopian tubes become accessible to ultrasound when fluid accumulates in their lumen, for example, an inflammatory process. When serous fluid or anechoic solutions accumulate in the fallopian tube, they speak of hydrosalpinx. A tube filled with hemorrhagic contents is called a hematosalpinx; filled with pus - pyosalpinx. Since there are no reliable ultrasound signs to determine the nature of the fluid, the term sactosalpinx is used - a saccular fluid formation. Sactosalpinx is formed in the absence of outflow of exudate through the uterine and abdominal openings of the fallopian tube.

Ultrasound diagnosis of acute salpingitis is possible only with sufficient accumulation of inflammatory exudate, when a formation adjacent to the posterolateral wall of the uterus begins to be visualized. With TVUS it is often possible to trace the connection of the formation with the tubal angle of the uterus. The fallopian tube in acute salpigitis can have an oval or curved fusiform shape with an expanded ampullary section, and can be represented by a two-chamber formation in the shape of “8” (sometimes a larger number of chambers is determined due to pronounced rotation of the tube). The walls of the fallopian tube are unevenly thickened to 5 mm or more, their echogenicity is increased. The contents of the tube are in most cases anechoic and homogeneous, but fine suspension and thickened incomplete echogenic septa (“gear wheels”) can be detected. Wall inclusions and intraluminal gas bubbles can be visualized. In the presence of pronounced bilateral sactosalpinxes, they can merge and form a single conglomerate in the retrouterine space. Unlike free liquid. the contents of the sactosalpinx do not move when the patient’s body position changes. Acute salpingitis is often combined with acute oophoritis. Fluid is often visualized in the retrouterine space. Dopplerography showed increased vascularization of the tube walls (RI<0.6). A chronic process is evidenced by an enlarged fallopian tube filled with an- or hypoechoic contents. The pipe wall thickness is less than 5 mm; incomplete partitions, often thin, can also be detected. 10% of patients have a moderate amount of free fluid in the pelvis. Doppler measurements indicate a decrease in blood supply to the walls of the pipe, RI>0.6. The absence of blood flow in the walls of the fallopian tube is an unfavorable sign of prognosis for cure, as it may indicate destructive changes in the tubes.

Hydrosalpinx can simulate varicose veins of the small pelvis, megaureter, and, if large, ovarian cystomas. It is important to determine the normal ovary on the same side. Disease of the pelvic veins is established using color circulation. If a megaureter is suspected, a connection with the bladder or renal pelvis is sought. Hematosalpinx can form when a tube ruptures, due to an interrupted ectopic pregnancy, during a tubal abortion due to detachment of chorionic tissue, and when blood is refluxed from the uterus. The contents of the hematosalpinx often have medium and increased echogenicity, with a possible heteroechoic structure. Pyosalpinx is most often bilateral. Ultrasound shows pronounced polymorphism depending on the severity of the process. Unlike hydrosalpinx, pyosalpinx often has the appearance of a multi-chamber formation due to changes in the walls of the fallopian tube. With its small size, pyosalpinx is practically indistinguishable from hydrosalpinx. The contents of the pyosalpinx are a heterogeneous echogenic suspension - purulent contents. The walls of the pyosalpinx are always hyperechoic and thickened.

With the progression of pyosalpinx, the formation of a tubo-ovarian formation and abscess is possible. When the infectious process spreads to the ovary, a tubo-ovarian formation and an abscess are formed on the side of the uterus and in the retrouterine space. The outline is usually unclear, the shape is oval or irregular. The ovary and tube can occlude but are defined as separate structures. In some cases, with TVUS it is possible to move the tube and ovary apart, but severe pain and perforation of the formation are likely.

An abscess is the next stage of the inflammatory process, with the “erasing” of the boundaries between the fallopian tubes and ovaries occurring. On ultrasound, a tubo-ovarian abscess is a complex formation in the area of the appendages with a predominance of the cystic component. Cystic cavities can be multiple, varying in size and shape. The structure of the conglomerate may contain hyperechoic inclusions with shadows - gas bubbles, partitions, suspension. With TAUS, the contours of the abscess appear blurred, and the ovary is not clearly identified. With TVUS in 205, it is possible to see the contour of the formation, find the wall and determine the blood flow in it. In the acute phase of inflammation, intensive blood supply is noted with a decrease in RI in the range of 0.4-0.6. Subsequently, blood supply decreases, RI increases. The size of a unilateral abscess is on average 50-70 mm, but can reach 150 mm. With bilateral localization of a tubo-ovarian abscess, it is not always possible to determine the boundaries between the pelvic organs. The inflammatory formation is represented by a single conglomerate of irregular shape, with a thickened capsule, multiple septa and heterogeneous contents. Diff. the diagnosis is made with an appendiceal abscess, a suppurating endometroid cyst, ovarian tumors of complex structure and an interrupted ectopic pregnancy.

Ectopic (tubal) pregnancy

In the vast majority of cases (95-98%), ectopic pregnancy is localized in the fallopian tubes. More often, the fertilized egg is implanted in the ampullary part of the fallopian tube (43-92%), less often in the isthmic part (13-40%), even less often in the interstitial part (2-3%).

Ectopic pregnancy manifests itself with an erased clinical picture and possible unfavorable outcome. Every woman of reproductive age with lower abdominal pain and menstrual irregularities (delay or acyclic bleeding) should be examined for ectopic pregnancy - a qualitative hCG test. TAUS makes it possible to exclude only early intrauterine pregnancy and sometimes progressive tubal pregnancy, ascertain the fact of a voluminous adnexal formation and free fluid in the paso-uterine space.

The combination of uterine and ectopic pregnancy is rare - 1 case in 4000-30000 pregnancies. The frequency increases with induced ovulation; with in vitro fertilization, there is a sharp increase in 1 case per 32-100 pregnancies. In 20% there are no echo signs of pregnancy.

Direct signs of ectopic pregnancy: ectopically located fertilized egg with a living embryo (a heartbeat that is different from the mother’s heart rate is determined). More often, a fertilized egg without an embryo is found in the fallopian tube, which then indicates a suspicion of tubal pregnancy. A fertilized egg with an embryo without a heartbeat is possible - a non-developing tubal pregnancy. Indirect signs of ectopic pregnancy include adnexal formation of a heterogeneous structure, the fertilized egg is absent in the uterus, and the pregnancy test is positive. The adnexal formation often has a fuzzy and uneven contour. In 15-85% of patients with ectopic pregnancy, the corpus luteum is determined, most often in the ovaries of the same side; characterized by intense low-resistance blood flow.

Moderate increase in uterine size in 20-30% of patients with ectopic pregnancy. Due to progesterone stimulation, the M-echo of the uterus thickens. Thickened endometrium (PZR 12-20 mm) has a similar structure to hyperplasia or the pattern of phase 2 of the menstrual cycle. Gravid hyperplasia during ectopic pregnancy occurs in 14-50% of cases. However, the M-echo can be thin (3 mm) with a non-developing or interrupted pregnancy. In 8-20% of cases of ectopic pregnancy, a false fertilized egg is determined in the uterine cavity due to the decidual reaction of the endometrium and the accumulation of blood with fragments of exfoliated endometrium.

In an ectopically located trophoblast, pronounced brightness during CDK indicates the intensity of blood flow; signals within the adnexal formation make it possible to delimit the zone of ectopic pregnancy from the tissues of the ovaries and corpus luteum - the “ring of fire” or “vascular ring”.

When ruptured as a rupture of the fallopian tube, a conglomerate with an uneven and unclear contour and a mixed echostructure is visible on the posterolateral surface of the uterus. The size of the formation and the amount of fluid in the retrouterine and lateral spaces depends on the duration of the interruption. Sometimes the uterine cavity is dilated, there is an accumulation of blood and rejected endometrium.

When interrupted by the type of tubal abortion, an enlarged fallopian tube filled with blood is visible, the fertilized egg is not visible, and there is a small amount of fluid in the uterus. Chronic or old ectopic pregnancy occurs when the tube ruptures incompletely, or when the process encystes. Posterior to the uterus there is a solid formation to which the sactosalpinx is adjacent. Peritrophoblastic blood flow is most often not detected due to necrosis; the hCG level is low for the same reason. Inflammation of the peritoneum and adhesions develop.

Fluid in the retrouterine space

In addition to ectopic pregnancy during the perovulatory period, inflammation of the appendages, rupture of an ovarian cyst, endometriosis, ascites. The vertical size is measured during a longitudinal scan of the uterus: 10 mm - insignificant; 10-30 mm - moderate; more than 30 is significant.

It is not possible to reliably determine the nature of the fluid. Peritoneal (serous) fluid, more often in the periovulatory period, the onset of inflammation, torsion of the appendages.

Hemorrhagic fluid has any echogenicity and accompanies a disturbed ectopic pregnancy, the postoperative period, rupture of adnexal formations, and sometimes endometriosis.

Purulent exudate is not completely anechoic.

Cysts and tumors of the fallopian tubes Sometimes thin-walled cystic formations adjacent to the fimbriae of the fallopian tube are small in size (up to 10 mm). Most likely - paramesonephric cysts or hydatids (Morgagni cysts).

Cysts of mesothelial origin or paratubar cysts can vary from single-chamber formations of 7-10 cm to multi-chamber formations up to 15 cm; distinguished by the presence of partitions.

Tumors of the fallopian tubes are rare, small in size, and are discovered during operations in the pelvis. Cancer of the fallopian tube is often represented by cystic adnexal tubo-ovarian formations with papillary growths, rhea of solid or mixed structure; it is necessary to see the ovary and tubal formation separately; blood flow is chaotic, RI <0.4.

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Preparation for ultrasound examination of fallopian tube patency

Unlike standard ultrasound of the pelvic organs, the study is carried out during the period from 7 to 12 days of the menstrual cycle.
Before the examination, you must take a smear to analyze the vaginal microflora, the result of which is valid for 21–45 days (the validity period must be clarified at the clinic where the procedure will be performed).
Prepare the results (if available) or perform a blood test for the following indicators: RW (syphilis), F-50 (HIV), hepatitis B and C (valid for 6 months).
It is necessary to ensure the absence of gases in the intestines during the procedure by following a special diet for 3 days aimed at reducing fermentation processes in the gastrointestinal tract (ban on eating flour, sweets, legumes, fruits and vegetables, milk and fermented milk, as well as carbonated drinks).
To ensure the cleanliness of the vagina, a week before the test you should stop using vaginal tablets, suppositories, sprays, douching, etc.
20 minutes before the procedure, it is necessary to take an antispasmodic drug (No-Shpa, Spazmalgon, etc.), which relaxes the smooth muscles and prevents possible reflex contractions of the cervix. In some clinics, the drug is administered by injection, immediately before the start of the procedure.

What does this examination method show?

If the fallopian tubes are patent, the ultrasound machine sensor detects the presence of a contrast agent in the abdominal cavity. The examination begins with the uterine cavity, then moves to the fallopian tubes and, if necessary, examines the ovaries.

This method reveals a congenital anomaly and allows you to determine the presence of polyps, fibroids, and endometriosis. Regarding the adhesive process, clear localizations of adhesions are determined, you can see the outline of the fallopian tubes, their location relative to other organs.

Upon completion of the procedure, a research report with a photograph is issued. It is advisable during the procedure to have your treating gynecologist present, who could watch the video examination, paying special attention to how the contrast agent passes into the uterine cavity (polyps, fibroids, fibroids, malformations, endometriosis can also cause infertility in a woman), and then into the fallopian tubes.

Hysterosalpingoscopy is a method that appeared not so long ago, and not every clinic can yet provide this service. However, this diagnostic method is the most informative, reliable and safe. The price for this procedure is low, since it is an outpatient procedure and is quite fast in terms of time; positive reviews from patients confirm this.

Malignant tumors

They occur in 1% of cases of all cancerous tumors in the female genital area and can be located as polymorphic, heterogeneous, pear-shaped, oval-elongated and indeterminate formations that resemble hydrosalpinx, pyosalpinx, uterine myomatous node on a long stalk. The only difference is the uneven contours; on their outer surface it is possible to locate papillary protrusions; in addition, rapid growth with clinical manifestations is noted. In any case, differentiating cancer from other non-malignant lesions using echography is difficult. The echographer should limit himself to describing the echo picture of the located space-occupying formation, conduct dynamic observation and, if necessary, perform a biopsy under ultrasound guidance.

Why choose ultrasound

The ultrasound method for the patency of the fallopian tubes, although performed according to the method described above, is quite simple to perform and does not cause any harm to the woman’s body. In addition to detecting pathologies that impair the patency of the fallopian tubes, diseases of the uterus are also detected. Such a study does not require any punctures or anesthesia. According to some data, irritation of the cervix and fallopian tubes can contribute to pregnancy, as the system that captures and transports the egg is activated.

Question and answer from an obstetrician-gynecologist-endocrinologist

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