Article overview
What is the fallopian tube?
The fallopian tube is also known as the uterine tube or oviduct. It is a paired muscular hollow organ in the form of a tube. The female reproductive organ is located in the small pelvis. It is responsible for transporting the egg cells from the ovary towards the uterus.
Anatomy of the fallopian tube
The fallopian tube has an average length of between 10 and 15 centimeters. It forms a kind of tube that connects the ovary to the uterus. The mature egg cell can safely pass through this tube. The fallopian tube is attached to the so-called broad ligament, a duplicate of the peritoneum, by a suspensory ligament (mesosalpinx). Doctors distinguish between several sections of the fallopian tube that make up the fallopian tube.
The tubal funnel
The tubal funnel, fallopian tube funnel or fimbrial funnel is a funnel-shaped section of the fallopian tube that is around 1.5 centimetres long. It opens into the free abdominal cavity (ostium abdominale). The fimbriae (fimbriae tubae uterinae), which are shaped like fringes, are located at this end. The egg is caught by the fimbriae attached to the ovary following ovulation. The egg is then transported to the uterus through a special tissue lining of the fallopian tubes.
Ampulla tuba uterinae
The ampulla tuba uterinae is the longest section of the fallopian tube. At 4 to 10 millimetres, it reaches the widest lumen and has a length of around 7 centimetres, which corresponds to two thirds of the length of the fallopian tube. There is a pronounced formation of folds on the tubal mucosa. These are responsible for transporting the egg cell.
Isthmus tuba uterinae
The isthmus tuba uterinae is a constriction in the fallopian tube, which is located close to the opening towards the uterus. It reaches a length of 2 to 3 centimetres and has a diameter of 2 to 3 millimetres. One of its characteristics is its massive wall musculature.
Part of the uterus (pars uterina tubae uterinae)
The pars uterina tubae uterinae is referred to as the uterine part. It runs along the uterine wall and attaches to the ostium uterinum tuba uterinae. It only reaches a maximum diameter of one millimeter.
Where is the fallopian tube located?
Like the ovary, the fallopian tube is located in the small pelvis. It is attached to the ampulla tuba uterinae and isthmus tuba uterinae by a duplication of the peritoneum. This is the so-called broad uterine ligament (ligamentum latum uteri). This is a duplicate of the peritoneum. Certain movements can be carried out by pulling certain muscles. The uterus, ovary and several loops of small intestine are located near the fallopian tube.
Blood supply to the fallopian tube
One ramus tubarius is responsible for the arterial vascular supply of the fallopian tube (i.e. the vascular supply that is proportionally responsible for the ovary). This branch emerges from the ovarian artery and the uterine artery (arteria uterina). They reach the fallopian tube via the mesosalpinx, another connective tissue covering of the peritoneum. Venous drainage takes place via the uterine venous plexus towards the uterine vein and partly via the ovarian vein (ovarian vein).
Nerves
The sympathetic nerve supply to the fallopian tube is provided by the inferior hypogastric plexus and the renal plexus. The parasympathetic supply is provided by the pelvic splanchnic nerves, which originate from the spinal cord segments S2 to S4.
Functions of the fallopian tubes
After a follicle has matured within the ovaries, the ovary is surrounded by the fimbriae. To do this, they straighten up and make rhythmic movements. Contractions then start from the fallopian tube.
Once the follicle has expelled the mature egg, it is absorbed by the fimbriae. The contractions are also stopped. If the mature egg reaches the fallopian tube, the ciliated cells start to move towards the uterus. Because the uterus is not able to move itself, the egg is transported in this way. The transportation can be accelerated by further contractions of the muscles. Approximately twelve hours after ovulation, the egg is considered ready for fertilization. If the female egg and male sperm meet during this period, fertilization occurs. This takes place in the fallopian tube.
Another important task of the fallopian tube is to transport the fertilized egg, the future embryo, to the uterus. This takes around three to five days. During transportation, the first cell divisions take place within the fallopian tube. At the 12 to 16-cell stage, the uterus is finally reached by the first zygote.
From the age of 40, remodeling processes take place on the fallopian tube wall, which end when the menopause is reached. They have no pathological value because the body merely adapts to the fact that pregnancies are no longer possible.
Diseases of the fallopian tubes
Various diseases can affect the fallopian tubes. One of the most common conditions is fallopian tube inflammation (salpingitis), which can affect either one or both fallopian tubes. The inflammation is caused by ascending bacteria that originate from the vagina, uterus or cervix. Fallopian tube inflammation manifests itself as pain in the lower abdomen, either as a constant ache or initially only at certain points, for example during sexual intercourse. In severe cases, discharge from the vagina, fever and fatigue also occur.
Antibiotics are usually administered for treatment. The course of the disease is usually mild. Occasionally, however, affected women also suffer from complications such as inflammation of the entire fallopian tube area and the surrounding area (adnexitis) or dangerous peritonitis. A dangerous complication is the adhesion of the fallopian tubes, which can lead to infertility (sterility).
Tubal adhesions
In some cases, inflammation of the fallopian tubes results in adhesions. These cause infertility in 20 percent of all patients in Germany. Fallopian tube adhesions occur when the upper open end of the uterine tube, where the fimbriae are located, becomes blocked. Infections from the vaginal tract are usually responsible for the adhesions. The ciliated epithelium can also be affected or a cavity filled with pus can form. The causes of tubal adhesions are bacteria such as
- Enterococci
- Escherichia coli
- Chlamydia
- Neisseria gonorrhea
It is not uncommon for the patient to initially experience no symptoms at all in the case of tubal adhesions, especially in the case of chronic inflammation, particularly chlamydial infections. However, symptoms such as fever and pain may occur as the infection progresses.
Ectopic pregnancy
An extrauterine pregnancy (EUG) is a pregnancy outside the uterus. In the case of an ectopic pregnancy, i.e. a pregnancy in the fallopian tube, the pregnancy is usually lost (gravidity). It also makes it more difficult for the women affected to get pregnant again. There is also an increased risk of another ectopic pregnancy occurring. In some cases, a fallopian tube rupture can occur, which can lead to life-threatening severe bleeding. The course of this complication depends on where the ectopic pregnancy occurs.
Conclusion
The fallopian tube is of great importance for the development of a pregnancy. It is therefore recommended that you consult a gynecologist as soon as possible if you have any symptoms.