Laparoscopy and dye test

If you're considering using a laparoscopy and dye test or have a test planned, you should know all you are able about this. This includes:

1. the reason why you need this test
2. what it really will be like
3. the way it will affect you
4. what risks are participating
5. any alternatives.

The information this is a guide to common medical practice. Each hospital and doctor may have slightly different ways of doing things, so you should follow their guidance where it's not the same as the information given here. Because all patients, conditions and treatments vary it wouldn't cover everything. Use this information when making your treatment choices together with your doctors. You need to mention any worries you have. Keep in mind that you are able to request more information anytime.

What's the problem?

You are having issues with becoming pregnant. This may be because your Fallopian tubes are blocked. In this test we inject dye through your cervix and into your uterus. If we have seen dye passing with the ends of your Fallopian tubes we all know they are not blocked.

What are the uterus, Fallopian tubes and ovaries?

To explain where your uterus, Fallopian tubes and ovaries are and what they do, the best place to begin may be the vagina. Your vagina is really a tube about five inches long. It runs from just before your rectum up into your pelvis. It is only behind your bladder. You are able to feel your bladder in your lower abdomen when it is full of urine.

Towards the top of your vagina is the uterus. It is about how big your clenched fist. It is made of special thick muscle, but it is hollow inside having a special lining known as the endometrium. The lowest a part of your uterus, which juts into your vagina, is ‘the neck of the womb’, also known as your cervix. Cervical smears are obtained from the top of your cervix.

Your uterus is called your body. It thins out at the very top to create two hollow tubes known as the Fallopian tubes. You've got a Fallopian tube on each side. These run sideways to finish near your left or right ovary. Your ovaries are slightly small compared to the golf ball. They lie deep inside your pelvis just beneath your waist. Your ovaries make hormones and contain tiny eggs, that are they canrrrt see with the human eye alone.

What do the uterus, Fallopian tubes and ovaries do?

The uterus is where an infant normally develops during pregnancy. About once a month an egg in one of the ovaries grows and breaks free of the ovary. It moves into the Fallopian tube and travels down the tube for the uterus. Simultaneously, hormones make the endometrium thicker so that if the egg is fertilised by a sperm it can lodge within the uterus.

Often, the egg is not fertilised also it dies. The endocrine system change and the endometrium also dies and it is shed. There's some bleeding from the raw endometrium during their visit. This can be a typical period. The cycle then starts again for the next month. If the egg is fertilised it starts making extra hormones. These make the uterus and endometrium grow to take the developing baby.

After age about 45 years the ovaries stop making some of the female hormones. Eggs are not released every month. The endometrium is not shed. The periods stop. This is known as the modification or the menopause. The alterations in hormones often cause hot flushes and dizzy spells. Sometimes the periods become very heavy during this period.

What has gone wrong?

Your Fallopian tubes may be blocked because of a past infection or by scarring, called adhesions, inside your pelvis. You might have another condition within your pelvis that's which makes it a hardship on you to conceive.

The aims

We use this test to find out in case your Fallopian tubes are blocked and, if so, why. As part of the test we do a diagnostic operation with keyhole instruments, known as a laparoscopy. Allowing us examine inside your pelvis having a telescope, called a laparoscope. We pass this through a small cut inside your abdomen. This may reveal a different cause for your pregnancy difficulties. The dye test part of the operation is called hydrotubation.

The benefits

If we find a clear cause of your pregnancy difficulties, such as blocked tubes, you can start the best treatment. If there are more causes, a laparoscopy is a very good way of detecting them. It may be possible to unblock your tubes using keyhole instruments during this operation. This may be just dividing a few adhesions that are causing the blockage. Using keyhole techniques is less painful than doing open operations, recovery is quicker and you avoid using a large scar.

What are the alternatives?

Ultrasound scans or x-rays could also give us some information about your tubes, but you are not usually as informative as a laparoscopy. A laparoscopy is generally better for finding the reason for any blockage and for seeing the health of your pelvic organs. Some specialists use culdoscopy. For this, instead of passing a telescope through your abdomen and into your pelvis we pass it through the wall of your vagina. It lets us see the outside of your uterus, Fallopian tubes and ovaries, along with the dye test we can see if your Fallopian tubes are blocked. The benefits of culdoscopy are that it leaves no visible scars on your abdomen and may be achieved using local anaesthetic. The disadvantages are that the view is not usually just like from a laparoscopy and it provides a higher risk of infection. Also we can't usually operate to remove a blockage throughout a culdoscopy. With a laparoscopy under general anaesthesia, if you require treatment, we may be able to do it immediately using the laparoscope. You may have a culdoscopy first a laparoscopy later on if you want treatment. Discuss the choices together with your gynaecologist.

What if you need to do nothing?

If you do nothing, your difficulties in becoming pregnant will most likely continue. If we don't be aware of reason for your problems we can't treat you.