Etiology
The most common cause is inflammation of the fallopian tubes or pelvic peritoneum. Chronic inflammation damages the mucosal lining of the tubes, leading to scarring, luminal narrowing, or complete obstruction. Causes are categorized into pathological, iatrogenic (human-induced), and congenital structural abnormalities.
In clinical practice, partial tubal blockage (referred to as “tubal stenosis”) often results from debris, sloughed cells, or menstrual blood clots within the tubes.
Pathological Causes
- Tuberculosis (TB) Infection
Tuberculous salpingitis, caused by Mycobacterium tuberculosis, remains a significant cause of tubal blockage, particularly in rural areas of China. - Bacterial Infections
- Pathogens such as Staphylococcus, Streptococcus, or Neisseria gonorrhoeae can ascend from the vagina or cervix into the uterus, fallopian tubes, or pelvic cavity, triggering pelvic inflammatory disease (PID) or severe systemic infections.
- Infections caused by Trichomonas vaginalis (a parasitic protozoan) have also been reported.
- Post-Abortion Complications
Acute pelvic inflammatory disease or salpingitis following induced abortions is a frequent contributor. - Endometriosis
Ectopic endometrial tissue within the fallopian tubes can lead to mechanical obstruction.
Iatrogenic Causes
Deliberate tubal occlusion methods for sterilization include:
- Tubal ligation: Surgical sealing, cutting, or clamping of the tubes.
- Hysteroscopic tubal occlusion: Chemical or mechanical blockage (e.g., Essure® devices).
Congenital Structural Abnormalities
Rare congenital defects include:
- Tubal Agenesis: Complete absence of one or both fallopian tubes.
- Hypoplastic Tubes: Abnormally narrow or excessively tortuous tubes.
- Intraluminal Obstructions: Developmental anomalies such as polyps or septa within the tubal lumen.
Note: Early diagnosis and tailored treatment are critical for managing infertility associated with tubal blockage.
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