Diseases of the female genital organs are dangerous not only for its presence, but also for its consequences. Especially traumatic in moral terms, those that lead to infertility. The great mission of becoming a mother loses its importance and oppresses a woman. Modern medicine is looking for and finds ways to cure such ailments, returning hope to a woman. Such unpleasant diseases include hydrosalpinx.
The disease is a pathological change occurring in the fallopian tubes. Deviations in lymph and blood circulation lead to the accumulation of fluid (transudate) in the cavity of the fallopian tubes. Since the fallopian tube enters into the uterus at one end, and the second is brought into the abdominal region, one of them becomes blocked, and then the fertilized egg does not have the opportunity to reach the uterus and get on its mucous membrane. And blame inflammation. However, the causes of the disease will tell more.
Prerequisites for the development of hydrosalpinx are salpingitis, adnexitis, salpingo-oophoritis - these are inflammatory processes that occur in the uterus, its appendages, in the fallopian tubes themselves. They are characterized by the formation of scars and adhesions that affect all layers of the fallopian tube. With the growth of these adhesions in the cavity of the fallopian tube accumulates mucus, leading to the formation of hydrosalpinx. Bacterial infections of gonorrhea, syphilis, and chlamydia can also be causes of hydrosalpinx.
The mechanism of hydrosalpinx progression is as follows: inflammation leads to the growth of connective tissue, adhesions and scars appear, they grow into the layers of the fallopian tube, disrupting the normal functioning of the muscle layer, fimbria grow together, the patency of the fallopian tube deteriorates, adhesions affect both ends of the tube and, as a result , hydrosalpinx formation occurs.
Having studied this mechanism, doctors determined the types of the disease.
Types and symptoms
The first division of hydrosalpinx into species is based on the number of cavities in the fallopian tube:
- simple form - one cavity is formed
- follicular form - several cavities are formed
Allocate and forms of the disease, correlated with its course:
Having defined the forms, it will be logical to proceed to their symptoms. For acute characteristic:
- production of serous exudate
- temperature rise
- pulsatile groin pain
- pronounced blush on cheeks, not typical on ordinary days
The chronic form develops slowly and for a long time, so there is no pain or other tangible signs, and the disease itself can only be detected with a pelvic ultrasound. If there is a lot of mucus in the tubes, then a woman may feel a foreign body and a heaviness in the groin area, pelvic pains are possible.
There is another type of disease that cannot be passed by - it is a valve hydrosalpinx. The adhesions in the fallopian tubes with this form have a loose structure and periodically erupt, pouring out streams of mucus. A natural symptom of the disease is a copious discharge of watery nature.
Well, we figured out the forms, let's move on to the methods of diagnosing hydrosalpinx.
Diagnosis of the disease is carried out in several stages. List all:
- Gynecological examination. When examining the uterus, the gynecologist probes a tight elastic formation located between the uterus and the ovary. It may have a rounded or ovoid shape. With pressure painless.
- Hysterosalpingography. This is an x-ray examination of the fallopian tubes, which determines the obstruction of the fallopian tubes. With a valve hydrosalpinx, the tube filled with a contrasting substance resembles a “tortuous sausage”.
- Ultrasound. Ultrasound shows the presence of fluid formation between the ovary and the uterus.
- Laparoscopy. It includes research and treatment.
When the diagnosis is established and confirmed, a treatment plan is drawn up.
To date, doctors offer two methods of treatment of hydrosalpinx - conservative and operative. Both of them are aimed at the resorption of fluid accumulated in the pipes and, ultimately, to restore their normal patency.
The initial stage of the conservative method, as a rule, provides for the elimination of inflammation, which led to the appearance of hydrosalpinx. In addition, antibiotic and physiotherapy are prescribed. In principle, such treatment has an effect only when salpingitis, salpingo-oophoritis and adnexitis, which were previously announced by us, become the cause of hydrosalpinx.
Thus, conservative treatment effectively affects the inflammatory process and is powerless in the fight against spikes and scars. And such methods as microclysters from decoctions of sage, chamomile, St. John's wort, which are advised by traditional medicine - are only supportive methods of therapy and do not lead to a cure.
The surgical method of treatment of hydrosalpinx, namely laparoscopy, is recognized as cardinal and really positive. The surgeon conducts plasticity of the fallopian tubes, removing adhesions and expanding the lumen. In severe cases, when it is obvious that the plastic does not restore the functionality of the fallopian tubes, they are removed because they are a source of chronic infection.
What is dangerous hydrosalpinx?
The disease disrupts the fallopian tubes, destroys the mucous membrane, and slowly but surely leads to ectopic pregnancy or infertility. Without timely treatment, the fluid between the adhesions accumulates and a dangerous source of infection is constantly present in the woman’s body. This is a negative fact for the IVF procedure, which doctors resort to, if infertility from hydrosalpinx could not be avoided.
Be careful and thrifty to your own health and do not exclude the joy of motherhood due to laziness or a stupid delay in visiting a gynecologist.
What is hydrosalpinx
Hydrosalpinx leads to scarring and adhesions. The muscular membrane at the same time loses the ability to reduce. In the fallopian tube begins to accumulate fluid, which is prone to inflammation.
In the absence of adequate treatment, the disease leads to complications, which include infertility, and with a successful pregnancy - the threat of not carrying and spontaneous interruption.
Symptoms of acute form
Acute hydrosalpinx is characterized by the production of serous exudate in the tube and the following symptoms:
- bursting throbbing in groin,
- increased temperature (38-39 degrees Celsius),
- heartbeat quickens,
- there is a strong blush on the cheeks.
Symptoms of the chronic form
Chronic hydrosalpinx develops slowly, characterized by gradual gluing of the fringe of the fallopian tube and accumulation of exudate in the cavity of the tube. No pain, as a rule, no, and the pathology is accidentally detected during the ultrasound of the pelvic organs.
With the accumulation of mucus, there is a feeling of a foreign body in the groin and a feeling of heaviness. Increased body temperature is not. Periodically appear pelvic pain.
With the “valve” hydrosalpinx, the adhesions are not dense, sometimes they break through with a stream of mucus, periodically emptying the pipe. This form of pathology is characterized by periodic abundant watery discharge.
Types of operations on the fallopian tubes:
Before we consider each species, we note that surgery is acceptable for women younger than 35 years old. Otherwise, the fallopian tubes are removed, because the inflammatory processes in them will interfere with the normal implantation of the egg.
Salpingostomy is an operation that results in a hole in the fallopian (fallopian) tubes. Through this opening, the fallopian tube is connected to the abdominal cavity.
Studies have shown that in the treatment of hydrosalpinx using these methods, pregnancy occurs only in 10-20% of cases. The reason is that the holes created after some time overgrow.
Therefore, it is preferable to laparoscopy, the purpose of which is to restore the patency due to the separation of adhesions both in the fallopian tube and around it. Laparoscopy does not interfere so much in the structure of the fallopian tubes, and therefore, if successfully performed, the probability of becoming pregnant increases significantly.
A successful laparoscopy does not mean complete restoration of the function of the fallopian tubes: the villi of the mucous are no longer so mobile, and the sheath of the muscles is not so reduced. This increases the risk of ectopic pregnancy.
What doctors to use when using hydrosalpinx
Hydrosalpinx: what is it?
Hydrosalpinx is a disease of the fallopian tubes, the result of which is a violation of their patency. The name of the pathology comes from the Latin words, where "Hydro" is translated as liquid, and "salpinks" means a pipe. The phrase often used by women - hydrosalpinx pipes - is wrong, just like oil is oil. A feature of the disease is the accumulation in the lumen of the fallopian tube fluid (transudate) due to blockage of the internal and external openings of the oviduct, as a result it turns into a saccular formation.
- right-side hydrosalpinx,
- hydrosalpinx on the left,
- bilateral hydrosalpinx.
It is wrong to use such combinations as acute and chronic hydrosalpinx. This pathology is a complication of the inflammatory process of the fallopian tubes - salpingitis, which can be both acute and chronic.
Example of diagnosis: Acute bilateral salpingo-oophoritis. Double sided hydrosalpinx.
A bit of anatomy and physiology
The fallopian tube (synonyms: fallopian tube or oviduct) is a paired organ and is presented as a hollow tube with two lumens. The length of the oviducts reaches 10–12 cm, and the right tube is somewhat longer than the left. One end of the oviduct opens into the uterine cavity, and the other ends with pili (villi) and opens into the abdominal cavity, not far from the ovary. Through these holes, the abdominal cavity communicates with the internal and external genital organs of a woman, which increases the risk of an ascending infection, for example, with vaginitis.
The wall of the oviduct consists of three layers:
- external - represented by the peritoneum and protects the pipe from negative influences,
- muscular - formed by muscle fibers and due to which the tube makes peristaltic (contractile) movements towards the uterine cavity,
- internal, covered with ciliated epithelium, the cilia of which move in waves (flicker), which facilitates the movement of a fertilized egg in the direction of the uterus, in addition, the glands located in the mucous layer of the tube, produce a secret that maintains the constancy of the internal environment of the oviduct and the viability of the egg, sperm and zygote.
The role of the fallopian tubes
Oviducts are necessary for the successful conception and implantation of a fertilized egg in the uterus. Tubal functions include:
- with the help of fimbria funnel tubes matured and released from the follicle egg is captured (time of ovulation),
- the egg cell moves to the ampulla section of the tube, where spermatozoa are delivered from the uterine cavity,
- maintaining the viability of germ cells (sperm and egg), preparing for their connection, direct fertilization,
- maintenance of the fertilized egg (zygotes) in the tube before moving it into the uterus,
- transportation of zygotes into the uterine cavity due to motility of the oviducts and increased activity of cilia of the ciliated epithelium.
Pathology development mechanism
Impaired functioning of the fallopian tubes occurs due to inflammation, for example, against the background of salpingitis or salpingoophoritis. As a result, connective tissue begins to grow and scars and adhesions form. The inflammatory process and adhesions capture all layers of the oviducts, with varying degrees of severity.
The fibers of the ciliated epithelium perish, and the muscular layer ceases to contract (peristalsis disappears). In the lumen of the fallopian tube, adhesions grow, which violates its permeability, and the funnel pimples stick together. When the adhesions close both openings of the oviduct, mucus begins to accumulate in the resulting closed space, intensively due to inflammation produced by the epithelial glands of the inner layer of the tube. As a result, the pipe expands to form hydrosalpinx or sactosalpinx. At suppuration of serous and mucous contents of a pipe piosalpinx is formed.
In some situations (incomplete soldering of fimbriae), a “valve hydrosalpinx” is formed, which periodically erupts due to the pressure of the accumulated liquid. The increase in pressure occurs with a sharp change in the position of the body, straining, in the process of conducting hysterosalpingography. When this transudate pours into the pelvis. Oviduct emptying at the “valve hydrosalpinx” occurs systematically. Infused inflammatory fluid stimulates the formation of adhesions in the pelvis - a vicious circle is formed, supporting the existence of hydrosalpinx.
Causes of hydrosalpinx
The formation of hydrosalpinx is due to the closure of the ampullar (middle) division of the fallopian environment, which is facilitated by the local inflammatory reaction. Infectious agents can penetrate into the cavity of the oviduct as an ascending path, from the lower organs of the reproductive system (cervix, vagina, uterus), and descending by blood flow (bladder and kidney, tonsils and intestines, appendix and others). Inflammation may be aseptic and occur in the presence of other gynecological diseases. The formation of hydrosalpinx occurs due to the following reasons:
- inflammation of the tubes, ovaries or appendages (salpingitis, oophoritis, adnexitis),
- inflammation of the uterus (endometritis),
- frequent and irregular change of sexual partners (genital infections: chlamydia, myco-and ureaplasmas, trichomonas, gonococci and others),
- female genital tuberculosis,
- wearing an intrauterine device,
- frequent hypothermia (weaken the immune system and activate opportunistic flora),
- abortion and diagnostic curettage of the uterus,
- long-term vaginitis and vaginal dysbacteriosis,
- inflammation of the cervix and cervix,
- external endometriosis (causes aseptic inflammation and the formation of adhesions in the small pelvis),
- myoma node in the entrance of the fallopian tube into the uterine cavity,
- sexual infantilism (tubes are thin, long and convoluted),
- damage to the oviducts during laparoscopy, followed by the occurrence of aseptic inflammation.
The following factors predispose to the formation of sacculate formation in the tube:
- neglect of the rules of intimate hygiene,
- stress, emotional stress,
- endocrine pathology: diabetes mellitus, diseases of the thyroid gland (weaken the body's defenses).
But I want to note that not always transferred and treated salpingitis or adnexitis ends with the formation of hydrosalpinx. With strong immunity and adequate and timely treatment, the inflammatory process in the tube disappears without consequences.
The clinical picture of the described pathology depends on the disease that caused it. When hydrosalpinx, which developed on the background of acute inflammation of the pipes, the symptoms are more pronounced. The patient is worried about febrile temperature, sharp, bursting pain in the groin (left or right), signs of intoxication: loss of appetite, lethargy and weakness. With the rapid accumulation of transudate in the ampullary section of the tube, the pain is arching and pulsating.
In the case of chronic salpingitis, accompanied by the formation of hydrosalpinx, patients are often not bothered by anything. Often, the only complaint is the impossibility of getting pregnant, and hydrosalpinx is found in the process of additional examination. But there may be complaints of discomfort in the ileal areas, the sensation of a foreign body in the groin, pain during intercourse. If there is a valve hydrosalpinx, then the woman may notice periodic abundant watery discharge from the genital tract (in the event of a breakthrough formation in the uterus). When transudate is poured into the pelvic cavity, adhesions are enhanced in it, which is manifested by chronic pelvic pain syndrome. Sometimes the symptoms of saccular tube formation resemble acute surgical pathology (appendicitis, renal colic or intestinal).
Typical signs of chronic salpingitis and formed hydrosalpinx are:
- discomfort or slight aching pain in the ileal region / areas
- menstrual disorders,
- pathological discharge from the genital tract,
- absence of pregnancies.
Pregnancy against hydrosalpinx
Against the background of hydrosalpinx it is possible to get pregnant, but in the event of damage to the pipe on one side only. Accordingly, the probability of conception is reduced by 50%.However, with this disease, the risk of tubal pregnancy and spontaneous abortion increases. Ectopic pregnancy is caused by damage to the ciliated epithelium in the affected tube and a violation of its motility. As a result, the fertilized egg is delayed in the oviduct for 4 or more days, where it is implanted and continues to develop.
Spontaneous abortion on the background of the saccular extension of the tube is explained by several points:
- mechanical action: periodically pouring fluid from the valve hydrosalpinx washes away the zygote from the endometrium surface, preventing it from implanting,
- the inflammatory transudate of hydrosalpinx, falling on the uterine mucosa, causes its damage and the development of endometritis, which makes implantation of the embryo impossible,
- perhaps the toxic effect of the inflammatory fluid on the embryo, which leads to its damage and death,
- The sensitivity of endometrial receptors to female sex hormones decreases, which leads to a violation of the hormonal regulation of the uterine mucosa of the implantation process.
If hydrosalpinx is diagnosed on both sides, then the occurrence of pregnancy in a natural way is impossible. In such cases, assisted reproductive technologies (IVF) are resorted to, although the effectiveness of in vitro fertilization and subsequent gestation of the fetus decreases several times (2-5).
If the pregnancy nevertheless occurred against the background of the existing sacculate expansion of the tube, then it may terminate spontaneously in the early and late periods. Therefore, all pregnant women with the presence of hydrosalpinx are at high risk of miscarriage. Treatment of the disease is postponed for the postpartum period.
This method consists in the introduction into the uterine cavity through the cervical canal of a contrast agent (under pressure). After that, X-ray images are taken. Hysterosalpingography allows to determine the patency of the pipes - the contrast is visualized in the small pelvis and to reveal hydrosalpinx. If there is a complication, the fallopian tube appears to be convoluted and thickened, and accumulated contrast is found in the extended ampullary region.
Most patients believe that hydrosalpinx can be treated with folk remedies. Doctors allow the use of traditional methods, but only as an addition to the first (conservative) stage of therapy. Means of traditional medicine will not help get rid of the disease, but only eliminate a number of symptoms: reduce pain, slow down the progression of inflammation and adhesions, more or less normalize the menstrual cycle. Of the recommended folk remedies, it is permissible to use:
- receiving pumpkin, potato and nettle juice (individually or mixed),
- microclysters with medicinal herbs (pharmacy chamomile, calendula, oak bark),
- receiving a mixture of aloe leaves, butter and honey,
- receiving oatmeal infusion
- reception of juniper baths (an infusion of berries and juniper branches is poured into the water, the water in the bath should be warm, but not hot),
- infusion of adonis,
- infusion of a mixture of herbs (camomile, currant leaf, sage, St. John's wort).
Once again I want to remind you that it is impossible to achieve a complete cure of the disease with the help of traditional medicine methods.
The second stage of therapeutic measures of this complication is surgical intervention. In the presence of hydrosalpinx treatment without surgery does not make sense. As long as the focus of inflammation remains in the pelvis, spike formation will continue, pain will persist and the chances of fertilization will decrease.
To date, laparoscopy is used as a surgical intervention with hydrosalpinx. Laparoscopic treatment of sacculate formation in the tube is the most gentle and effective surgical intervention. In the course of laparoscopy, depending on the condition of the tubes, the patient's age and her desire to become pregnant, the following types of surgical intervention are performed in the anatomy of the oviducts:
- salpingoovariolysis - adhesions around the oviduct and ovary are dissected, their anatomical location is restored, and adhesions in the lumen of the fallopian tube are separated,
- fimbriolysis and fimbrioplasty - fimbriae of the final section of the pipe, which are adjacent to the ovary, are released from adhesions, the inflammatory transudate is removed from the pipe, if necessary, fimbriae plastic is performed,
- salpingostomy and salpingoneostomy — they form a new opening in the ampullary section of the oviduct or are released from adhesions of the anatomical opening (minus salpingoneostomy — a new opening is very quickly overgrown),
- tubectomy - removal of a pipe / tubes (performed on women over 35 years old or if it is impossible to restore the patency of the oviduct and eliminate hydrosalpinx).
But even in the case of a successful operation, preserving the pipe and restoring its patency, the oviduct does not function as before. Villi of the ciliated epithelium either lose mobility, or the epithelium itself atrophies, and the muscular layer is not able to contract in the previous mode, that is, the peristalsis of the tube is disturbed, so patients are put at risk for ectopic pregnancy, and the onset of pregnancy is recommended by IVF.
Do I need to comply with any restrictions in this disease?
Yes, sure. First, you should avoid physical exertion (vibration, straining, abrupt change in body position: somersaults, tilts, jumps). Secondly, to avoid excessive activity during intercourse, which increases pain. In addition, it is not recommended to sunbathe and visit the solarium, as well as visits to the baths, saunas and hot baths, which can provoke an exacerbation of the inflammatory process. It is undesirable to swim in the pool and open water, as local hypothermia also provokes aggravation. It is forbidden to drink alcohol, including low-alcohol beverages, which suppresses immunity.
Double sided hydrosalpinx
The fallopian tubes are known to be a paired tubular organ, a hollow double-lumen tube that starts from the uterus and ends with fimbriae (fringe) that capture the egg cell. The fallopian tubes are located on both sides of the uterus.
Thus, with bilateral hydrosalpinx, fluid accumulation occurs in the left and right parts. In this case, conception by natural means is impossible.
However, one-sided hydrosalpinx is more common in women. Despite this, inflammation occurs in both fallopian tubes, which reduces the chances of getting pregnant.
Factors that increase the likelihood of occurrence and development of hydrosalpinx:
- the presence and progressive formation of adhesions in the fallopian tubes and endometrial folds,
- obstructed blood circulation in the pelvic organs,
- pathologies and abnormalities of the pelvic organs,
- lymph circulation disorder
- inflammation of the fallopian tubes,
- previous inflammatory processes of the reproductive organs,
- infections and sexually transmitted diseases,
- bowel disease.
Questions and answers on "Hydrosalpinx"
Question:Hello, I have a hydrosalpinx on the right side, but the left pipe is passable, but there is no pregnancy for 4 years now, can the hydrosalpinx of the right side affect the passable left side why there is no pregnancy, is it necessary to delete it.
Answer: The probability of pregnancy with unilateral hydrosalpinx is halved. Surgical treatment increases the chances of getting pregnant and reduces the risk of ectopic pregnancy. In addition, it would not be superfluous to check her husband (spermogram).
Question:Hello! My left saltosapinks was determined for 2 years. She underwent several ultrasounds, which showed saltosapinks on the left. Went to laparoscopic surgery - the right appendages were removed. How can this be? And the pain on the left does not pass. I am 58 years old.
Answer: Hello! This question should be asked to the attending physician, the surgeon and their management. Or immediately to RosMinZdrav: telephone "hot line" 8 800 200-03-89.
Question:Hello! I was diagnosed with double-sided hydrosalpinx. Now I am undergoing tests for IVF, the doctor did not say anything. Do IVF with this diagnosis? Maybe they just dismiss me.
Answer: Hello! In connection with the widespread use of IVF, many reports have appeared indicating a significant number of cases of ineffectiveness of the procedure in women with hydrosalpinx. The frequency of implantation of a fertilized egg, embryo development and gestation of pregnancy in them is 2-5 times lower compared with women with other causes of infertility. In most cases, fertility specialists advise the implementation of IVF and as a preparatory stage - surgical salpingectomy (removal of the uterine pathological tube), after which the probability of pregnancy as a result of IVF increases by more than 2 times. Consult the reproductologist in person.
Question:Hello! I am 24 years old, undergo examination before planning pregnancy. In September, Lindinet OK quit drinking. In the second cycle, after the cancellation, an ultrasound scan was performed on day 19 of the cycle, according to its results: Pathological formations in the small pelvis: two-dimensional anechoic obrzvanie in the area of right appendages 16x11 mm. Otherwise, everything is fine, there is a dominant follicle in the right ovary. The ultrasound doctor diagnoses: the ultrasound picture corresponds to the peri-ovulatory phase of the cycle, possibly hydrosalpinx! Where did he come from? Just a month ago, I was at the doctor’s office, and before that I was constantly examined and the ultrasound scan did, never this happened! And is it possible that the ultrasound doctor confused this hydrosalpinx with a paraovarial cyst on the right of approximately the same size, which I found about 3 years ago on several ultrasound (done in another clinic). And how can this be cured, because I am planning a pregnancy?
Answer: Hello! Hydrosalpinx is a disease of the fallopian tubes, characterized by a violation of their patency with accumulation of fluid in the lumen of the tube. The fluid in the lumen of the pipe when hydrosalpinx has a non-inflammatory origin. It is a blood plasma that is sweating through the walls of blood vessels, extracellular fluid, and the natural secretion of the fallopian tubes, which accumulate in the cavity of the tube due to the impossibility of emptying it. The direct mechanisms causing the development of hydrosalpinx are narrowing or complete overlapping of the lumen of the fallopian tube and impaired blood circulation in its wall. Your question about the fact that the doctor may have mistaken a paraovarial cyst for hydrosalpinx is fair. To clarify the diagnosis, I recommend to repeat the ultrasound on the 5th day of the menstrual cycle. You should also contact your gynecologist to decide the necessary issues related to pregnancy planning.
Question:Hello, tell me, can hydrosalpinx disappear without treatment? From the beginning of December, an ultrasound scan was visible (in February and March, too), there should have been an operation, today an ultrasound scan was done and there was nothing (they did the same). Could it appear again?
Answer: Hello! During treatment, the fluid may disappear, but not the fact that the anatomy of the fallopian tube has recovered. Be sure to check the patency of the fallopian tubes.
Signs and symptoms of hydrosalpinx
Usually the disease is asymptomatic. A small amount of transudate can cause pitting pains in the pelvic region on the one hand, heaviness. As the fluid gradually stretches the walls of the oviduct, complaints of severe pain are rare. It may appear during sex, while performing some exercise.
Sharp pains on the one hand, accompanied by increased heart rate, cold sweat indicate a rupture of the pipe, and emptying the contents into the abdominal cavity. Unlike pyosalpinx, in the diagnosis of hydrosalpinx, peritonitis does not always develop, but the probability of bleeding from their damaged pipe is high.
Often there is a valve form, in which the fluid is emptied into the lumen of the uterus. At the same time, a woman has abundant leucorrhea (mucous discharge). Emptying does not mean the restoration of patency and cure, since the process is usually recurrent. This is due to the fact that adhesions remain, and their rupture promotes the re-formation of fibrin filaments. In addition, when the tube cavity is stretched, its normal peristalsis is disturbed, which also contributes to the formation of adhesions.
So, the symptoms of hydrosalpinx can be:
- nagging pain in the lower abdomen, they may increase during intercourse,
- mucous discharge,
- difficulty conceiving.
Often a woman does not feel any discomfort, and the pathology is detected when going to a doctor for infertility. Hydrosalpinx is one of the causes of tubal infertility. Moreover, infertility in this pathology may be associated not only with the patency of the pipes. Periodic abundant emptying of the transudate can physically “wash off” the blastocyst, which is especially important if the woman, due to infertility, has decided to turn to the help of assisted reproductive technologies and do IVF.
There is also evidence that the exudate contains a large amount of bioactive substances that adversely affect the embryo, contributing to early miscarriage. Therefore, if a woman is shown to undergo IVF, in order to reduce the risk of unsuccessful procedures, it is recommended to have laparoscopic tubectomy done in advance.
Symptoms of hydrosalpinx usually appear on the background of chronic salpingitis, and during exacerbations it can lead to suppuration of the effusion, the formation of pus, pyosalpinx, and subsequently to peritonitis. If during hydrosalpinx the rise in body temperature is short-term, does not exceed 37.4-37.7 degrees Celsius, then pyosalpinx is characterized by fever, increased heart rate, weakness. The consequences of pyosalpinx are very dangerous, therefore, when such symptoms are detected, a visit to the doctor cannot be postponed.
If a woman is diagnosed with hydrosalpinx, his treatment requires surgery, which is performed by laparoscopy or laparotomy. It is necessary to cut the adhesions that prevent the outflow of fluid. When the outflow is restored, it is required to continue treatment with conservative methods.
The laparoscopic method for this type of intervention is preferred because it has the following advantages:
- Minimally invasive and less traumatic operation. Three small incisions are made through which endoscopic equipment is introduced and the modified oviduct is removed.
- Fast recovery after surgery, on the second day the patient is allowed to walk, and after a week to lead a normal life, with the exception of strong physical exertion and weight lifting.
- The absence of contact with air during the laparoscopic method prevents the formation of new adhesions.
Patients with the aim of preventing the formation of adhesions early raise, bed rest is shown only in the first hours after surgery, until the patient leaves after anesthesia. Then they are allowed to sit, get up, walk under the supervision of medical staff or caregivers.
After surgery, conservative treatment is prescribed, which includes:
- antibiotic therapy
- anti-inflammatory substances
- absorbable drugs.
Physiotherapy shows good effectiveness.
- laser phoresis,
- magnetic therapy
- electrostimulation of the fallopian tubes
- mud therapy
It is quite difficult to restore the patency of the tube, since even after getting rid of adhesions, it is not always possible to achieve full restoration of the ciliary epithelium, thanks to which the fertilized egg moves from the ovaries into the uterine cavity. This can lead to an ectopic pregnancy, so if a woman does not plan to have children, then it is better to remove the modified tube when treating hydrosalpinx.
The likelihood of becoming pregnant with one tube with a unilateral process remains, but if both tubes are damaged, the risk of developing an ectopic pregnancy is high, which is dangerous for a woman. Experts recommend for infertility on the background of hydrosalpinx to resort to assisted reproductive technologies. But you need to do a tubectomy, because the modified tubes are a source of infection, support the inflammation of the endometrium, reduce the chances of getting pregnant with IVF.
Prevention of hydrosalpinx
Prevention of hydrosalpinx is the prevention of the development and timely treatment of inflammatory processes in the reproductive organs and the abdominal cavity. To do this, it is necessary to increase the body's resistance and reduce the risk of infection.
For the prevention of hydrosalpinx it is recommended:
- avoid accidental connections, use barrier methods of protection (condoms),
- plan a pregnancy so you don’t have to do the scraping
- eat right, food should be rich in vitamins and minerals to enhance overall immunity,
- lead a healthy, active lifestyle,
- do sport.
Such preventive measures will help increase overall immunity and avoid infection with various infections. Если заражение все же произошло, нельзя лечиться самостоятельно.You need to consult a doctor to get a full diagnosis and treatment. Inadequate treatment of STDs leads to a chronic process.
The AltraVita clinic employs gynecologists, urologists, reproduction specialists, who have extensive experience in combating STDs, diseases of the reproductive system, infertility, as one of the complications of hydrosalpinx. If you have symptoms of infection of the genital tract infections, signs of damage to the pipes or problems with conception, you can contact us.
Our specialists will conduct a full examination and prescribe treatment. The clinic has all the necessary equipment for this, a modern laboratory. If you are worried about infertility, we will try to help, overcome it. AltraVita reproductive specialists have been using assisted reproductive technologies (IVF) for the treatment of infertility, including tubal, for 15 years. Contact us and we will do our best to restore your health, and if necessary, help to conceive and carry out the child.
Saktosalpinks - the general name of the pathology of the fallopian tubes, in which occurs with the accumulation of its cavity and filling with liquid contents. With hydrosalpinx, the contents of the saccular cavity are represented by a clear serous fluid, with pyosalpinx - by pus. Pathology can have unilateral or bilateral localization.
By morphological features distinguish simple and follicular (multichamber) hydrosalpinx. A simple form is diagnosed when a single closed cavity forms in the fallopian tube, follicular forms when several cavities are formed, which are separated by adhesions. In cases where the saccular cavity is periodically emptied, and its contents are poured into the uterine cavity and then out, the valve (or drained) hydrosalpinx is diagnosed. The course of hydrosalpinx can be acute (active phase of inflammation) or chronic (sluggish inflammation). The size of hydrosalpinx varies from one to several centimeters.
Symptoms of hydrosalpinx
Hydrosalpinx, small in size, with an inactive inflammatory process, as a rule, does not manifest itself in any way and is detected by chance during routine ultrasound of the pelvic organs. With a significant accumulation of fluid and overstretching of the tube, there is a feeling of heaviness in the lower side abdomen, chronic pelvic pain. Body temperature may periodically rise to subfebrile numbers. When the patient drains the hydrosalpinx, a periodic discharge from the genital tract of abundant, watery whitening is noticed.
In the case of acute inflammation, a rise in temperature up to 38 ° -39 ° C is noted, intense arching or throbbing pains radiating to the groin. Sometimes the clinic hydrosalpinx resembles acute surgical pathology (appendicitis), intestinal or renal colic. Severe malaise, hectic fever, chills, myalgia, as a rule, indicate the development of pyosalpinx.
Violation of patency of the fallopian tubes due to hydrosalpinx directly affects the reproductive function. If the lumen of the tube closes completely, this makes it impossible for an egg to get into it and fertilization — so-called tubal infertility develops. Therefore, it is often the unsuccessful attempts of a woman to become pregnant that cause a gynecologist examination. However, even if the lumen is not fully closed, damage to the ciliated epithelium, smoothness of folding of the mucous membrane and atrophy of muscle fibers cause a violation of the peristalsis of the tube and, as a result, the development of ectopic pregnancy. Hydrosalpinx not only prevents the onset of pregnancy in a natural way, but also several times reduces the effectiveness of in vitro fertilization. The presence of hydrosalpinx supports the course of chronic endometritis, which also affects the success of ART methods.
A serious complication of hydrosalpinx can be a rupture of the fallopian tube, the occurrence of which is indicated by a sudden sharp pain in the corresponding half of the abdomen, tachycardia, hypotension, pallor of the skin, cold sweat. In case of rupture of pyosalpinx, the likelihood of peritonitis, pelvioperitonitis, and Douglas abscess is high. In some cases, pus breakthrough does not occur in the abdominal cavity, but in the bladder, vagina or rectum.
Hydrosalpinx and IVF
Research in the field of reproduction convincingly prove the negative impact of hydrosalpinx on the IVF forecast. At the same time, the chances of a successful embryo replanting are not only reduced many times, but also the risks of an ectopic pregnancy and spontaneous abortion in early periods increase. This causal relationship is explained by a number of pathological effects that the contents of hydrosalpinx can cause:
- Mechanical action. It is assumed that the draining hydrosalpinx, emptying into the uterine cavity, can “wash out” the early embryos.
- Embryotoxic action. In addition to the direct mechanical removal of embryos from the uterus, the contents of hydrosalpinx has a destructive effect on them. Liquid from hydrosalpinx contains large quantities of microorganisms and their toxins, lymphocytes, prostaglandins, proinflammatory cytokines, etc., which have a pronounced cytotoxic and embryotoxic effect. This effect persists even at 50% dilution of hydrosalpinx contents.
- Endometrial damage. With the help of morphological and immunohistochemical methods, pathological changes of the endometrium in the conditions of the existence of hydroalpinx are revealed. Decrease in local immunity, expression of progesterone and estradiol receptors, decrease in subendometrial blood flow, structural disorders of the glandular and stromal components of the endometrium — any of these factors may cause a violation of embryo implantation.
Forecast and prevention of hydrosalpinx
Hydrosalpinx is fraught with low chances of pregnancy, both when attempting to self-conceive, and within the framework of IVF protocols. Functional reconstructive surgery does not always allow achieving the desired pregnancy in a natural way; therefore, tubectomy with a subsequent IVF cycle (.
Prevention of hydrosalpinx is the prevention and adequate treatment of PID (salpingoophoritis, endometritis) and STDs, excluding casual sexual intercourse, refusal of abortion, regular gynecologist supervision.
Chronic hydrosalpinx on the left or on the right is already an advanced stage of the disease. It is characterized by a “blurred” clinical picture, it flows almost imperceptibly, causing irreparable harm to the reproductive system of a woman. The constant presence of inflammation and exudate disrupts the fallopian tubes. They lose their ability to reduce and elasticity.
But the greatest pathological changes relate to the ciliary layer of the oviduct. The cilia, the small outgrowths on the mucous membrane of the reproductive organ, are designed to help the fertilized egg reach the uterus. They seem to roll the zygote, because it is devoid of organs of motion. But when dropsy occurs, the cilia stick together, and therefore their natural function is disturbed.
Two-sided hydrosalpinx in our time is becoming more common. Such a diagnosis suggests that oviducts on both sides suffer (Hydrosalpinx on the right, left). Bilateral lesion of the reproductive system dramatically worsens treatment predictions and increases the risk of infertility. According to statistics, right-sided and left-sided lesions of the fallopian tubes occurs with the same frequency.
What is a valve hydrosalpinx
It happens that the spike overlaps the oviduct, but the connective tissue has a softer, more pliable texture. As the fluid accumulates in the pipe, the pressure inside the cavity increases many times, which leads to over-expansion of the walls.
The fluid begins to press on the connective tissue with such force that the spike does not stand up, and the possibility of an outflow of exudate is formed, which breaks either into the uterus or into the abdominal cavity.
All of the above and occurs when the valve hydrosalpinx! The fallopian tube acquires a partial patency, which in many cases helps a woman to become pregnant. Hundreds of cases have been documented in which women have become mothers even with enormous dropsy.
But a breakthrough fluid can cause irreparable harm, especially when using IVF (in vitro fertilization). An embryo conceived outside the woman’s body and then transferred to her uterus may simply be flushed away by a stream of exudate. Thus, all the efforts of fertility specialists (doctors on artificial insemination) fail. That is why more and more often before conception “in the test tube” it is recommended to remove the fallopian tube operatively.
Causes of Hydroalpinx
The mechanism of the onset of the disease is not fully understood, but the causes of hydrosalpinx include:
- congenital abnormal development of reproductive organs,
- disruption of lymph flow through the lymphatic ducts,
- abdominal surgery,
- previous ectopic pregnancy
- endometrial abnormal growth,
- perforated appendicitis,
- adhesive disease in the pelvic area,
- circulatory disorders and / or chronic foci of inflammation in the reproductive organs,
- previously experienced sexually transmitted diseases, especially Chlamydia and Gonorrhea,
- some bowel pathologies.
The reasons for bilateral hydrosalpinx are identical to the above items.
Symptoms of Hydrosalpinx
Symptoms of Hydrosalpinx are very diverse. These include:
- watery vaginal discharge. They may be cloudy or have a sero-purulent structure,
- pulling pains in the area of projection of appendages. Their intensity is moderate
- during exacerbation of the disease, women note a rather sharp rise in temperature to 39 degrees. Celsius.
Much less common is a long rise in temperature, unexplained weakness, fatigue, poor general well-being, depressive, poorly treatable psychological states. These signs are identical for Hydrosalpinks on the right and on the left.
All signs of hydrosalpinx can manifest with varying degrees of intensity, which increases the risk of incorrect or late diagnosis. Sometimes the woman herself delays with gynecological consultation, only aggravating her position.
Today, various methods for the differential diagnosis of the disease are available. These include:
- Ultrasound (ultrasound). Hydrosalpinx on ultrasound looks like a liquid pathological inclusion, with localization in the space between the ovary and the uterus itself. Such echoprism is a decisive factor in making this diagnosis,
- gynecological examination,
- hysterosalpingography (hydrosalpingography (GHA),
- laparoscopy. It should be noted that hydrosalpinx laparoscopy can be not only detected, but also cured.
Treatment without surgery is the first step towards getting rid of the disease. To combat the inflammatory process, treatment with broad-spectrum antibiotics is used. Such drugs are prescribed not only in injections, but also in tablets and suppositories, which only simplifies the treatment. Be sure to prescribe Longidase, as the drug is ideal for the treatment of this disease.
In order to mobilize the body's own forces, supplements are also prescribed fortifying, vitamin, absorbable drugs and medicines that remove excess fluid from the tissues. The effect of drugs is enhanced by physiotherapeutic procedures and laser therapy.
Treatment of hydrosalpinx: auxiliary methods
Spa treatment is especially indicated for women with chronic bilateral hydrosalpinx. Mud baths have a powerful absorbing effect that will certainly benefit in this disease. After all, if the fallopian tubes restore patency, then the probability of pregnancy will increase many times.
Homeopathy is another auxiliary method of treating ailment. The benefits of taking homeopathic drugs are highly controversial, lacking evidence and not accepted by official medicine. But, after detailed consultation with a specialist, you can try this method of winning over the disease.
On the forms of those women who cured the disease, it is increasingly possible to find positive reviews about the treatment with leeches. Even wise Chinese doctors for thousands of years saved a woman from diseases of the reproductive system through the use of a special type of leeches. Then this technique was unfairly forgotten, but today it is experiencing a real “boom” of popularity.
Long since this pathology was treated with propolis. For the preparation of tinctures use only high-quality raw materials or buy the finished product in the pharmacy. For home cooking take alcohol (60%) and mix it with crushed propolis (40%). Use the tincture to rub the skin of the abdomen on the affected side.
In folk medicine, decoction of anti-inflammatory herbs is used as a medicinal microclyster. Actively apply the treatment of juice, which is combined with erytherapy.
It should be remembered that traditional medicine cannot become the main treatment, even if a mild degree of this pathology is detected. Folk remedies - only an addition to the complex treatment!
Treatment of the disease by hydrosalpinx surgery
Sometimes it happens that the treatment of Hydrosalpinks can continue only through surgery - removal of dropsy. When hydrosalpinx is removed, the most often used sparing technique is laparoscopy.
For its implementation requires the latest optical technology, through which cleaned dropsy without abdominal opening of the abdominal cavity, which minimizes the risk of postoperative complications, reduces the likelihood of adhesions and bleeding, does not bring serious cosmetic defects.
After the stage of removal of dropsy, the surgeon conducts the plasticity of the oviduct, restores its patency, excised commissural scars and restores re. Hydrosalpinks laparoscopy has a number of contraindications that your gynecologist will warn you about.
Some women suffer from a real phobia, making it difficult to perform the operation on time and find the joy of motherhood. In such cases, a competent gynecologist will definitely advise visiting the thematic forums, where you can easily communicate with people who have overcome identical problems.
At these sites, you can see a photo and listen to a video about the stages of surgery, get acquainted with the symptoms and duration of the postoperative period, learn the standard of laboratory tests. But if fear remains an insurmountable obstacle, then, without hesitating, you should go to a professional psychologist.
As you can see, Gidrosalpinsk is the most serious disease, because the prevention of the disease should be dealt with immediately after the birth of a girl. The duty of parents to teach a girl or teenager is careful about their health. The child should be aware of the importance of reproductive health, because by all means convey to him useful information. Woman - come from childhood. And if children and adolescents passed in compliance with all the rules for the prevention of the disease, then the risk of finding a pathology as an adult already decreases significantly.