What is bilateral tubal phimosis?
Bilateral tubal lephimosis is a narrowing of both fallopian tubes, usually responsible for infertility in women. This phenomenon is defined by a degradation and aggregation of the fringes of the fallopian tube, thus blocking the union between the egg and the sperm. This condition is often identified during a fertility evaluation, and its intervention may require surgery to restore the patency of the tubes.
Tubal phimosis refers to a narrowing or partial obstruction of the distal end of the fallopian tube (pinna/fimbria side).
When it is bilateral, it means that both fallopian tubes are affected.
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Are there specific causes for bilateral tubal phimosis?
The main causes of bilateral tubal phimosis are linked to damage or after-effects affecting the fallopian tubes
Genital and Pelvic Infections Salpingitis (infection of the fallopian tubes).
Sexually transmitted infections (especially Chlamydia trachomatis and Neisseria gonorrhoeae).
Genital tuberculosis (rarer).
Sequelae of pelvic inflammatory disease
Pelvic inflammatory disease (PID).
Post-infectious adhesions.
Endometriosis
Endometriotic deposits around the fallopian tubes causing adhesions and narrowing of the tubal ridge.
Prior pelvic surgery
Operations on the ovaries, uterus, fallopian tubes, or appendix can cause adhesions.
Ectopic pregnancy Especially if it has affected both fallopian tubes.
Rarer causes
Congenital malformations.
Sequelae of pelvic trauma.
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Situations that suggest tubal phimosis:
Bilateral tubal phimosis does not cause any direct symptoms in everyday life (no particular pain or visible signs). It is usually discovered in the context of infertility.
Difficulty getting pregnant after 12 months of regular unprotected intercourse (primary or secondary infertility).
History of salpingitis or genital infections (chlamydia, gonococcus)
History of ectopic pregnancy.
Chronic pelvic pain (sometimes in cases of endometriosis or adhesions).
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Tests that allow diagnosis:
Hysterosalpingography (HSG) X-ray with injection of a contrast agent into the uterus.
Allows to see if the fallopian tubes are open or blocked.
Hysterosonography (ultrasound with contrast agent)
Less invasive, uses air bubbles or saline.
Laparoscopy (surgical examination with a camera) This is the gold standard.
Allows direct visualization of the fallopian tubes, confirmation of phimosis, and sometimes simultaneous treatment (salpingoplasty).
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