The main function of the uterine tubes, also known as the fallopian tubes, is to assist in the transfer and transportation of the ovum or egg from the ovary to the uterus. The ultra-structure of the uterine tubes facilitates the movement of the female gamete. The inner mucosa of the tubes is lined with ciliated columnar epithelial cells and peg cells. These non-ciliated secretory cells are responsible for wafting the ovum towards the uterus and providing it with essential nutrients. In addition, the smooth muscle layer of the uterine tubes is responsible for contracting to assist with transportation of the ova and sperm. This muscle is sensitive to sex steroids, and therefore peristalsis is greatest when the levels of oestrogen are high.
The fallopian tube of the uterine tubes is effectively split into four parts, from lateral to medial: fimbriae, infundibulum, ampulla, and isthmus. The fimbriae are finger-like, ciliated projections that capture the ovum from the surface of the ovary. The infundibulum is a funnel-shaped opening near the ovary, to which the fimbriae are attached. The ampulla is the widest section of the tubes, and is the location in which fertilisation usually takes place. Finally, the isthmus is the narrow section of the uterine tubes, connecting the ampulla to the uterine cavity.
The arterial supply to the uterine tubes is via the uterine and ovarian arteries. The venous drainage is managed by the uterine and ovarian veins, while the lymphatic drainage is via the iliac, sacral and aortic lymph nodes.
The uterine tubes receive both sympathetic and parasympathetic innervation via nerve fibres from the ovarian and uterine (pelvic) plexuses. Afferent fibres for sensory purposes run from T11- L1.
The clinical relevance of the uterine tubes relates to a condition known as salpingitis, which is the inflammation of the tubes usually caused by bacterial infection. As a result, adhesions of the mucosa may occur, partially or completely blocking the lumen of the uterine tubes. This poses a risk of infertility or, in some cases, an ectopic pregnancy.
An ectopic pregnancy is a medical emergency, due to the risk of haemorrhage and rupture of the affected tube if it is not diagnosed in a timely manner. This occurs when sperm are able to pass through the partially occluded lumen of the uterine tube and fertilise the ovum, however, the fertilised egg is unable to pass into the uterus and instead implants in the uterine tube. Surgical cutting of the uterine tubes is a common elective method of sterilisation.
There are two main methods of ligation. The first is via open abdominal, which is performed via a suprapubic incision. The second method is laparoscopic, which is performed via a fibre-optic laparoscope inserted via a small incision near the umbilicus.
The uterine tubes (also known as the fallopian tubes) are structures of the female reproductive tract located on either side of the uterus. These tubes are responsible for transporting ova from the ovary to the uterus and sperm from the uterus to the ovary. Anatomically, the uterine tubes consist of three distinct portions – the interstitial, isthmic, and ampullar portion. The uterine tubes receive their vascular supply from the ovarian artery and veins and the utero-ovarian ligament, and are innervated by the ovarian and uterine plexuses of the autonomic nervous system.
The primary role of the uterine tubes is to facilitate the passage of ova from the ovaries into the uterus. However, in some cases the fertilised egg may fail to pass into the uterus. This is known as an ectopic pregnancy, and is a medical emergency, as the implanted blastocyst can cause rupture and haemorrhage of the affected tube if not diagnosed early. Other clinical issues that relate to the uterine tubes include ligation of the uterine tubes and salpingitis.
Surgical cutting of the uterine tubes is a method of sterilisation. This procedure prevents the oocyte from passing into the uterus and, in turn, prevents the progression of a pregnancy. Two main methods of ligation exist: open abdominal and laparoscopic.
The open abdominal approach involves making a suprapubic incision through the abdominal wall. The laparoscopic method involves inserting a fibre optic laparoscope through a small incision near the umbilicus.
Salpingitis is an inflammatory condition of the female genital tract caused by infection of the uterine tube. The cause of the infection is usually microbial pathogens, such as chlamydia, gonococcal and non-gonococcal bacteria. Salpingitis is associated with a wide range of symptoms, including pain in the lower abdomen and pelvis, fever, and abnormal vaginal discharge.
The primary treatment for salpingitis is the administration of antibiotics to treat the infection. However, in some cases, surgery may be necessary to remove any damaged tissue. The prognosis for salpingitis is generally good, although some women may experience fertility problems due to the infection.
