Symptoms of hydrosalpinx and methods of treating tubal obstruction

• January 10, 2019
• Gynecology
• Oleg Petrov

Treatment of hydrosalpinx without surgery is required by a large number of patients, as this is a very common gynecological disease. When it is formed, the reproductive function of the female body is disrupted. In this case, characteristic pathological changes in the fallopian tubes occur. When peristalsis is disrupted, liquid contents form in their lumen. This disease is often correlated with dropsy of the fallopian tubes. Impaired patency occurs due to the formation of light yellow or transparent exudate, consisting of extracellular fluid, plasma, and secreted secretions. Most experts consider hydrosalpinx as an independent disease, in some cases as a complication of inflammatory processes occurring in neighboring tissues and organs. It is believed that hydrosalpinx is one of the main reasons preventing pregnancy. There are a large number of reasons for the formation of pathology, which we will discuss in this article. To eliminate the disease, surgical or conservative treatment methods are used.

Features of the pathology

Treatment of hydrosalpinx without surgery is possible if certain conditions are present, which we will discuss in detail in this article. It is worth noting that various adhesive processes and inflammatory reactions developing in the fallopian tubes lead to significant changes in this paired organ. First, the lumen narrows, in some cases it can be blocked completely, and then a cavity is formed filled with liquid contents. This becomes the main obstacle to natural fertilization.

One of the main difficulties in treating hydrosalpinx is that the pathology is very difficult to diagnose, especially in the early stages.

The fact is that most of the symptoms of the disease are similar to a large number of other gynecological diseases.

It is possible to establish pathology only subject to a full and comprehensive examination of the pelvic organs, using instrumental and laboratory diagnostic methods.

Thorough examination

This is a very unpleasant pathology, so all women should know as much as possible about hydrosalpinx, what it is and how to treat it. Only a professional gynecologist can make a correct diagnosis in such a situation by conducting a full gynecological examination. It must necessarily include a number of procedures.

Initially, the woman is examined by a doctor on a gynecological chair with palpation of the area of ​​the uterine appendages. Depending on the location of the formation of the source of the disease, it is determined on which side the hydrosalpinx formed. After a smear is taken for bacteriological analysis of vaginal discharge, it is important to carry out an additional examination of the cervical area.

At the next stage, it is important to carry out an ultrasound examination of the pelvic organs using a transvaginal sensor. This will help determine the presence of a cavity formation, clarify its structure and size. Hydrosalpinx appears quite well on ultrasound.

It is important to do laparoscopy in order to determine possible treatment methods and timely diagnosis of this pathology.

The essence of this procedure is to identify areas of the fallopian tubes that are formed as a result of significant proliferation of connective tissue.

With the help of laparoscopy, it becomes possible to diagnose pathological changes in the villi that regulate the advancement and capture of the egg.

Finally, testing for sexually transmitted diseases allows you to determine the most likely cause of the disease. For this, cultures are taken from the vagina and cervical canal and a blood test.

This pathology develops in a paired organ called the fallopian tube. Because of this, the inflammatory process is often not limited to damage to only one pipe.

Bilateral hydrosalpinx is considered a particularly severe pathology, with the development of which the ability for natural pregnancy decreases significantly.

Therefore, the fallopian tubes are an organ whose condition requires increased attention.

It is worth noting that hydrosalpinx and natural pregnancy are interrelated concepts. In the presence of pathology and the absence of adequate treatment, irreversible consequences may occur for the reproductive system.

Symptoms

One of the main dangers is that it is often not possible to suspect this disease on your own. It is often determined by chance, for example, hydrosalpinx appears on an ultrasound of the pelvic organs. The pathology can only be recognized by a qualified gynecologist, having established the presence of this disease using the methods already listed in this article. Then he must explain to the patient what it is and how to treat hydrosalpinx.

One of the most obvious symptoms that may indicate this disease is pain of varying intensity in the area of ​​the fallopian tubes. Pain with hydrosalpinx can be bursting in the chronic form and pulsating in the acute stage.

Also among the signs of the disease are:

1. A sudden and significant rise in body temperature, accompanied by pain.
2. Inability to get pregnant for a long time.
3. General intoxication, which can be manifested by pale skin, vomiting, nausea, fatigue and lack of appetite.
4. With hydrosalpinx, vaginal discharge becomes watery, its smell and color changes due to the addition of bacterial flora.
5. When changing body positions, sharp pain appears, for example, when turning the body or suddenly rising.

All these symptoms can be observed with other diseases of the genitourinary system. Because of this, women often mistake such discomfort for a minor disorder, so they self-medicate without seeking help from a gynecologist. This behavior is unacceptable.

Causes

The occurrence of this pathology is often indicated by the expansion of the fallopian tube. If you have such a disorder, you should immediately seek help to establish the original causes of the disease.

It is worth noting that if a mechanical obstacle occurs in the form of a filled cavity in only one tube, the probability of getting pregnant still remains quite high. When a gynecologist diagnoses the process on both sides, you can forget about natural pregnancy.

Please note that fluid accumulates in the fallopian tubes for several reasons:

• diseases of the appendages or ovaries;
• abnormalities in the development of reproductive organs;
• inflammatory processes developing in the uterine cavity;
• inflammation in the cervical canal or uterine cavity;
• infection of pathogenic flora due to the constant emergence of new sexual partners;
• venereal diseases;
• surgical operations on the pelvic organs, which provoke the development of adhesions and inflammatory reactions;
• infection with Mycobacterium tuberculosis;
• use of intrauterine contraceptives;
• inflammatory diseases in the vagina, which change the flora and last for quite a long time;
• the appearance of myomatous nodes in the tubes and uterine cavity;
• previous miscarriages and abortions;
• curettage of the uterine cavity for the purposes of prevention or diagnosis;
• ectopic pregnancy;
• systemic diseases of the pelvic organs;
• stress;
• hypothermia of the pelvic organs and the body as a whole.

Treatment options

If you are wondering whether hydrosalpinx can be cured, rest assured that it is not that difficult. True, in some cases this may take quite a long time - several years.

Quite often the method of treating hydrosalpinx with antibiotics is used. It is based on the use of local and systemic medications, which are often used in conjunction with homeopathy, physiotherapy, and grandmother’s recipes.

The conservative method demonstrates high efficiency in detecting partial adhesion of villi. It is based on anti-inflammatory and antibacterial therapy. Treatment of hydrosalpinx without surgery is possible, but only in simple cases, without complications.

At the same time, you should be prepared that you will achieve a positive result only by strictly adhering to the recommendations of your doctor.

When choosing a specific antibacterial drug, preference should be given to those drugs that have a broad antimicrobial effect against various types of pathogenic strains.

So, to eliminate adhesions, Longidase is used for hydrosalpinx. This drug has a resolving, decongestant, antioxidant and regenerating effect. It improves the elasticity and permeability of tissues. Under the influence of the drug, proteins are broken down, which prevents scarring in the fallopian tube.

To treat hydrosalpinx without surgery, this drug is used in the form of tablets or suppositories (rectally or vaginally).

Physiotherapy

When treating this disease, it is important to maximize the body’s own strength.

Therefore, along with antibiotics, immunomodulators of plant or synthetic origin are prescribed as a general strengthening therapy. For example, “Viburkol” or “Immunal”.

Also, in addition to the main treatment, the use of physiotherapy is practiced. In this case, it includes electrical stimulation of the fallopian tubes, endovaginal massage, ultraviolet irradiation, and magnetophoresis. Some patients are recommended mud therapy, in particular, in sanatoriums in Crimean resorts.

Grandma's recipes

Treatment with folk remedies for hydrosalpinx has a general strengthening and anti-inflammatory effect. It is considered solely as a symptomatic treatment. As a rule, in the form of taking decoctions or herbal infusions, baths.

It is important that you cannot limit yourself only to folk remedies and self-medicate without consulting a gynecologist.

Only complex therapy, when taking herbal preparations accompanied by antibiotics, brings a positive effect.

Here are some common and effective methods.

Use aromatherapy with essential oils of cypress, eucalyptus, and pine needles. Teas with Canadian goldenseal and echinacea also help, which, first of all, strengthen the immune system.

An effective remedy is oat decoction. One glass of chopped oats should be poured with a liter of boiling water, and then left for at least ten hours. Afterwards it needs to be boiled and then strained. Take 100 ml orally three times a day. It is advisable to do this before meals. The full course of therapy is ten days.

Another effective method is based on acacia. To prepare it, take 10 g of fresh acacia flowers with a teaspoon of its bark. Fill with water and let it brew for a while. The infusion should be stored in a dark and cool place for at least ten days. When the time has come, you can take the tincture 30 minutes before meals, 25 drops.

Pour a glass of boiling water over Adam's root, and then wrap it in a warm blanket. Let the product sit for two to three hours, then take it three times a day, one teaspoon.

Often, special healing baths are taken for hydrosalpinx. Firstly, from a variety of herbs. For example, they take juniper berries along with their stems. In total, you will need 50 g of this mixture, which is poured with ten liters of boiling water. After two hours, you need to strain it and then take a bath.

By the way, instead of juniper, you can use cabbage leaves with the same effect. Secondly, clay baths help many people. To do this, pour liquid natural clay into a large container, slowly immersing your hands into it. They should be left in this position for half an hour. After this, the feet are lowered into the solution. These baths should be taken at least four times a day.

If it is very hot outside at this time, you can immerse yourself in the bath entirely.

Drink juices for hydrosalpinx. Traditional healers advise preparing them from nettles, potatoes and pumpkin. The effect of such drugs will be especially high.

Pumpkin juice helps relieve general swelling in the body. You can also douche with a decoction of herbs or use a tampon previously soaked in the decoction.

You can pour boiling water over two teaspoons of Adam's root. This tincture should be taken one teaspoon no more than three times a day.

Surgical method

The surgical treatment of hydrosalpinx involves its removal. It is believed that this is the optimal method, which is characterized by a favorable prognosis.

In essence, it consists of performing fallopian tube plastic surgery. First, interfering adhesions are removed, and then the lumen is expanded to the required level using laparoscopy. If complications occur, tubectomy, that is, complete elimination, can be used.

The surgical method is recommended when the patient has systemic diseases. For example, for problems with the thyroid gland or diabetes. In these cases, as a rule, it is not possible to independently defeat the infection that attacks the body.

Dangerous consequences

This is a disease that must be treated, as otherwise everything can result in unpleasant consequences.

If no action is taken or this disease is not treated in a timely manner, this can lead to the loss of the opportunity to become pregnant on your own. The consequences of hydrosalpinx can be very dire. As a rule, ectopic pregnancy, infertility, significantly reduces the chances of in vitro fertilization.

In some cases, the disease can develop into a purulent-inflammatory form, in which case it is especially dangerous. In this situation, pyosalpinx develops. This occurs when an infection joins an existing hydrosalpinx.

As a result, chronic inflammatory and infectious diseases of the pelvic organs are highly likely to worsen or develop. In particular, we are talking about endometritis, salpingo-oophoritis, and some other ailments.

This is why hydrosalpinx of the fallopian tube is dangerous.

The happiness of motherhood

Regardless of what method of treatment was determined by the gynecologist, the main condition for defeating this disease is to carefully follow all the recommendations of the gynecologist, then you will be able to successfully cope with the disease.

Only if you take good care of your health, timely treatment of systemic diseases, adhere to the rules of personal hygiene, and the absence of casual sexual contacts, will you be able to significantly increase your chances of motherhood.

To avoid such problems, prevention of this disease is effective. In addition to the above points, you should give up bad habits, use barrier-free methods of contraception, such as condoms, and regularly visit a gynecologist, at least twice a year.

Source: https://SamMedic.ru/446139a-lechenie-gidrosalpinksa-bez-operatsii-metodyi-preparatyi-narodnyie-sredstva

Hydrosalpinx, what is it and how to treat it?

A common gynecological disease that disrupts the reproductive function of the female body is hydrosalpinx. It is characterized by a pathological change in the fallopian tubes (impaired peristalsis) with the formation of liquid contents in their lumen. This disease is often synonymized with dropsy of the fallopian tubes. The formation of a transparent or light yellow exudate, consisting of blood plasma, extracellular fluid and secreted secretions, occurs as a result of a violation of the patency of the tubes.

Hydrosalpinx is considered as an independent disease or as a complication of inflammatory processes in neighboring organs and tissues. Hydrosalpinx is considered one of the reasons that prevents pregnancy. The causes of the pathology are very diverse and in any case require elimination by a conservative or surgical method.

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Etiology of the disease

This pathology is quite difficult to diagnose, especially at an early stage. The main symptoms of the disease are similar to other gynecological diseases. Pathology can be identified through a comprehensive examination of the pelvic organs (using instrumental and laboratory research methods).

The standard examination includes the following procedures:

1. Examination of the patient by a doctor on a gynecological chair with palpation of the area of ​​the uterine appendages. Depending on the location of the source of inflammation, hydrosalpinx on the left or hydrosalpinx on the right is determined. They also perform an additional examination of the cervical area and take a smear for bacteriological examination of vaginal discharge.
2. Ultrasound examination of the pelvic organs and in particular the use of a transvaginal sensor. In this way, the presence of a cavity formation (bag) can be determined, its size and structure can be clarified.
3. Laparoscopy performed for the purpose of timely diagnosis and possible treatment. The essence of this procedure is to identify compacted areas of the fallopian tubes formed as a result of the proliferation of connective tissue, and to determine the films (adhesions) lining the internal cavity. Laparoscopy allows you to diagnose pathological changes in the fimbriae (villi that regulate the capture and advancement of the egg).
4. The hysterosalpingographic research method, when a colored substance is injected into the cervical canal under pressure, allows you to capture an abnormally dilated area of ​​the fallopian tube using x-rays.
5. Testing for sexually transmitted diseases allows you to diagnose the probable cause of the disease (blood test, cultures from the cervical canal and vagina).

Pregnancy that occurs naturally and hydrosalpinx are interrelated concepts. The presence of the disease and the lack of adequate treatment threatens with irreversible consequences for the reproductive system.

Characteristic symptoms of the disease

The following symptoms may indicate the presence of hydrosalpinx:

• pain of varying intensity (pulsating in the acute stage and bursting in the chronic form) in the area where the fallopian tubes are located;
• inability to get pregnant for a long period;
• watery vaginal discharge (the addition of bacterial flora changes its color and smell);
• a sharp rise in body temperature, combined with pain;
• phenomena of general intoxication in the form of pale skin, nausea and/or vomiting, lack of appetite, fatigue;
• the appearance of pain when changing body position (sudden rise or rotation of the body).

The listed symptoms are observed in many genitourinary diseases. This contributes to the fact that women in most cases self-medicate, delaying the moment of meeting with a gynecologist.

Reasons contributing to the occurrence of exudate

Timely diagnosis helps to quickly eliminate the root cause of the disease.

When a mechanical obstacle in the form of a formed filled cavity is present in one tube, then the chances of getting pregnant always remain.

A bilateral process of fallopian tube damage diagnosed by a doctor sounds like a death sentence for a woman. Fluid may collect in the fallopian tubes due to the following reasons:

• abnormalities in the development of the reproductive organs (for example, sexual infantilism, manifested by thinning and tortuous fallopian tubes);
• diseases of the appendages (ovaries) in the form of salpingitis, adnexitis;
• inflammatory processes in the uterine cavity (endometriosis);
• inflammation in the cervix and cervical canal (ectropion, erosion, endocervicitis);
• infection with pathogenic flora (bacteria, viruses and fungi) as a result of frequent changes of sexual partners;
• sexually transmitted diseases (existing or present in the past);
• infection with Mycobacterium tuberculosis;
• surgical intervention on the pelvic organs, provoking inflammatory reactions and the development of adhesions;
• use of intrauterine contraceptives (spiral, cap);
• the presence of myomatous nodes in the uterine cavity and tubes;
• long-term inflammatory diseases of the vagina, changing its flora;
• previous abortions, miscarriages;
• ectopic pregnancy;
• curettage of the uterine cavity for diagnostic or preventive purposes;
• the presence of systemic diseases of the pelvic organs;
• general hypothermia of the body and pelvic organs;
• stress factor.

Treatment

1. Conservative method. It is based on the use of systemic and local medications in combination with physiotherapy, homeopathy and traditional medicine.
2. Surgical method. Surgical removal of hydrosalpinx is the optimal treatment option with a favorable prognosis.

Hydrosalpinx, depending on the location of the inflammation and the cause of its occurrence, requires an individual treatment regimen for each woman.

If partial soldering of villi (fimbriae), characteristic of hydrosalpinx, is detected, a conservative method of treatment is used, based on the use of antibacterial and anti-inflammatory therapy. A non-surgical treatment option is used in uncomplicated cases.

To achieve a positive result, you need to be patient and strictly adhere to the recommendations of your doctor.

When choosing an antibacterial drug, preference is given to drugs with a broad antimicrobial effect against many types of pathogenic strains.

To eliminate adhesions, Longidaza is included in the complex of prescribed drugs. This drug has a decongestant, absorbable, regenerating, and antioxidant effect. Improves permeability and elasticity of fabrics. The breakdown of proteins under the influence of the drug prevents scarring in the fallopian tube.

In order to obtain maximum effect, the attending physician prescribes the drug immediately after diagnosis. Application can be oral (in the form of tablets), vaginal or rectal (in the form of suppositories).

Activating the body’s own forces is an important stage in the fight against the disease. The use of immunomodulators of synthetic or plant origin (Immunal, Viburkol) and vitamin complexes is indicated as strengthening therapy.

Treatment with traditional medicine using phytocompositions with anti-inflammatory and restorative characteristics is considered as symptomatic treatment in the form of herbal infusions and decoctions for bathing.

You can choose to use chamomile, calendula, yarrow, oak bark, St. John's wort and other plants. It is impossible to cure the disease with herbs alone. This should always be remembered.

Any decision made must be agreed with the attending physician.

Surgical treatment is used when two fallopian tubes are affected, or conservative treatment does not give a positive result.

Despite the fact that this method is the most effective, most women try to resort to it as a last resort.

Removal of the fallopian tubes forever deprives a woman of the hope of becoming pregnant naturally and forces her to resort to in vitro fertilization. In advanced cases, surgery cannot be avoided.

The surgical method is presented in the form of fallopian tube plasty (removal of adhesions and expansion of the lumen to the required level) through laparoscopy. In severe cases, tubectomy (complete elimination) is used.

Regardless of the treatment tactics prescribed by the doctor, strict adherence to a set of measures aimed at eliminating the disease is the determining factor. Taking good care of your health, following the rules of personal hygiene, avoiding casual sex, and treating systemic diseases greatly increases your chances of experiencing the joy of motherhood.

Source: https://DrLady.ru/disease/gidrosalpinks-chto-jeto-takoe-i-kak-lechit.html

Hydrosalpinx

Hydrosalpinx - what is it, symptoms and methods of treatment One of the consequences of inflammation of the uterine appendages, in particular its tubes, is hydrosalpinx. According to statistics, this pathology is present in 10-30% of women who are planning pregnancy, but it does not occur due to the fact that hydrosalpinx prevents successful conception.

However, with adequate timely treatment, a long-awaited pregnancy is possible, so there is no need to try to get rid of the pathology by resorting to self-medication. This approach will only aggravate the pathological process and delay the onset of the long-awaited conception, and in particularly advanced cases, pregnancy may not occur at all.

What it is?

Hydrosalpinx (from ancient Greek ǔδωρ - “water” and σάλπιγξ - “pipe”) is a one- or two-sided saccular expansion of the fallopian tube, filled with a clear serous non-infected fluid (transudate), formed against the background of inflammation due to soldering of the ampullary part of the fallopian tube. [adsense2]

Structure and physiological functions of the fallopian tube

It is also called the oviduct. It is a hollow, with a lumen width of up to 1 mm, paired anatomical formation about 10-12 cm long, connecting the fundus of the uterus with the pelvic cavity. With one hole, the fallopian tube opens into the uterine cavity. Its distal end ends on the ovary and contains a second opening, bordered by fimbriae.

The walls of the fallopian tube consist of three membranes - serous, muscular and mucous. The serous membrane covers the outside of the oviduct, the muscular membrane consists of two differently directed layers of smooth muscle fibers, which provide the oviduct with peristalsis (contractions) in the direction from the ovaries to the uterus.

The mucous membrane forms longitudinal folds and is a layer of cells of cylindrical ciliated epithelium with villi. Between the epithelial cells are glandular cells that secrete mucus into the lumen of the tube.

This mucus ensures the constancy of the internal environment of the tube, helps maintain the activity of sperm, the viability of the egg and the embryo in the early stages of its formation.

During the period of ovulation, the egg is captured by the fimbriae and then, as a result of peristalsis and vibrations of the villi of the ciliated epithelium, moves into the uterine cavity. Mucus secreted by glandular cells also freely enters the uterine cavity.

So, the physiological functions of the fallopian tubes are:

1. Capture of an egg through fimbriae at the moment of its release from the follicle into the abdominal cavity (ovulation).
2. Ensuring the movement of the egg and delivery of sperm from the horn (corner) of the uterus to the egg.
3. Ensuring the vital activity of germ cells, preparing them for fusion and creating conditions for fertilization.
4. Movement of the embryo into the uterus through peristalsis and increased activity of the epithelial cilia.
5. Ensuring the development of the embryo until the implantation of the fertilized egg in the uterus.

The mechanism of pathology development

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 affect all layers of the oviducts, with varying degrees of severity.

The villi of the ciliated epithelium die, and the muscle layer stops contracting (peristalsis disappears). Adhesions grow in the lumen of the fallopian tube, which impairs its patency, and the fimbriae of the funnel of the tube stick together.

When the adhesions close both openings of the oviduct, mucus begins to accumulate in the resulting closed space, intensely, due to inflammation, produced by the glands of the epithelium of the inner layer of the tube. As a result, the tube expands, forming a hydrosalpinx or sactosalpinx.

When the serous-mucosal contents of the tube suppurate, a pyosalpinx is formed.

An increase in pressure occurs with a sudden change in body position, straining, or during hysterosalpingography. In this case, the transudate flows into the pelvis. Emptying of the oviduct with “ventilated hydrosalpinx” occurs systematically.

The overflowing inflammatory fluid stimulates the formation of adhesions in the pelvis - a vicious circle is formed that maintains the existence of hydrosalpinx.

Causes of hydrosalpinx

The formation of hydrosalpinx occurs as a result of the closure of the middle (ampullary) section of the oviduct; this occurs in response to a local infectious and inflammatory reaction.

Infectious agents penetrate into the cavity of the fallopian tube both through the ascending route, from the lower organs of the reproductive system (cervix, uterus, vagina), and downward, namely through the bloodstream from the appendix, intestines, tonsils, kidneys, and bladder.

Inflammation can be aseptic and occur in the presence of gynecological diseases.

Hydrosalpinx is formed due to the following reasons:

• wearing an intrauterine contraceptive device;
• diagnostic curettage of the uterine cavity and abortions;
• frequent hypothermia (activation of opportunistic microflora against the background of weakened immunity);
• inflammation of the appendages, ovaries, tubes (andexitis, oophoritis, salpingitis);
• promiscuous sex life and frequent changes of partners (sexually transmitted infections: gonococci, trichomonas, ureaplasma, chlamydia);
• endometritis (inflammation of the uterus);
• myomatous node located at the entrance of the oviduct into the uterine cavity;
• adenomyosis;
• damage to the oviducts during laparoscopy with the occurrence of aseptic inflammation;
• sexual infantilism (twisted, long, thin pipes);
• external endometriosis (causes aseptic inflammation and the formation of adhesions in the pelvic area);
• inflammation of the cervical canal and cervix;
• vaginal dysbiosis and long-term vaginitis.

Predisposing factors that increase the risk of developing hydrosalpinx:

• emotional stress, stress;
• neglect of the rules of personal intimate hygiene;
• endocrine pathologies: thyroid diseases, diabetes mellitus (weaken the body’s defenses).

It is worth noting that treated and transferred andexitis or salpingitis does not always result in the occurrence of hydrosalpinx. In the presence of a strong immune system, as well as adequate timely treatment, inflammatory processes in the fallopian tube disappear without consequences. [adsen]

Classification

There are hydrosalpinx:

Right-handed	the pathological process affects only the right fallopian tube.
Left-handed	the pathological process affects only the left fallopian tube.
Bilateral	Both tubes are affected. Most often, with this form of pathology, complete infertility develops (the inability to get pregnant on your own).
Simple	a process limited to one cavity of the fallopian tube.
Follicular	a process in which cavities are formed, formed by the growth of adhesions that divide the lumen of the fallopian tube into several chambers.
Ventilated	The fluid accumulated inside the tube, due to its pressure and elasticity of the internal adhesions, breaks into the uterine cavity, and then out through the vagina.

Symptoms

Very often, hydrosalpinx is completely asymptomatic at the very beginning. The woman is mainly concerned about the symptoms of the primary disease against which it arose. As the disease develops, signs that differ from the main pathology gradually begin to appear, the intensity of which increases. They make you wary and run to the doctor to find out the causes of concern.

But it often happens that a woman tries not to pay attention to the discomfort for a long time, attributing everything to premenstrual syndrome, physical overload, ovulation, and so on, thereby aggravating the condition. What are the symptoms of pathology?

1. Persistent nagging pain in the lumbar region of varying intensity.
2. Nagging pain in the lower abdomen, which subsides from time to time and returns again (the greatest intensity is on the affected side).
3. Menstrual irregularities.
4. Rise in body temperature to subfebrile levels (no more than 37.5°C).
5. General malaise (weakness, dizziness, etc.).
6. A feeling of fullness in the lower abdomen, which is more intense on the side of the affected tube.
7. Unsuccessful attempts to conceive a child.
8. Discharge from the genital tract. With any type of hydrosalpinx, there is an increase in the secretion of leucorrhoea (which is very typical in the presence of an inflammatory process). Periodic watery discharge from the vagina may also be observed (characteristic of the ventral type of pathology), as a result of which all symptoms temporarily subside until the fallopian tube is filled with fluid again.

[adsense2]

Diagnostics

Diagnosis of the disease we are considering is carried out in several stages. These include the following:

1. Ultrasound. An ultrasound examination determines the presence of a fluid formation between the ovaries and the uterus.
2. Gynecological examination. In this case, it is possible to identify between the ovary and the uterus a tightly elastic formation of an ovoid or round shape, which, as a rule, is painless or slightly painful.
3. Laparoscopy. As in a number of other gynecological diseases, this method is not only diagnostic, but also therapeutic.
4. Hysterosalpingography. The nature of the x-ray picture may be similar to the nature of fallopian tube obstruction. In the case of valve sactosalpinx, filling the tube with a contrast agent determines its external resemblance to a twisted “sausage”.

Possible complications

Complications of hydrosalpinx can include:

• ectopic (tubal pregnancy);
• miscarriage;
• suppuration of hydrosalpinx (pyosalpinx);
• adhesions in the pelvic cavity;
• infertility;
• in the case of IVF – ineffectiveness of the procedure, spontaneous termination of the resulting pregnancy;
• rupture of the fallopian tube.

Treatment of hydrosalpinx

It is almost impossible to treat hydrosalpinx without surgery. The treatment program includes two stages.

At the first stage you need:

• determine the nature of structural damage in the affected pipe (one or both);
• establish the source of infection and determine the appropriate antibacterial drug to eliminate it.
• identify concomitant infectious and inflammatory changes in the vagina, uterus and cervical canal;
• find out how far the inflammatory process has spread, whether there are signs of inflammation in the ovaries or in the pelvic cavity;
• diagnose existing dyshormonal disorders.

The complex of therapeutic measures at the first stage of treatment for hydrosalpinx includes antibacterial, anti-inflammatory therapy and physical therapy. Most often, the first stage of treatment is preparatory, and after it an operation is performed to remove the hydrosalpinx using the laparoscopic method.

Sometimes patients try to treat hydrosalpinx without surgery on their own, using randomly selected antibacterial agents or using traditional medicine recipes.

This practice does not bring the desired benefit or leads to an imaginary recovery when the symptoms of the disease disappear, but the chronic process continues to progress and can lead to rupture of the fallopian tube.

The next stage of treatment involves not only removing the hydrosalpinx itself, but also restoring the patency of the fallopian tube. Laparoscopy successfully copes with both tasks.

Laparoscopic surgery to remove hydrosalpinx is the most effective method of treating infertility, and also represents the most reliable diagnostic method, allowing the doctor to see the changes occurring in a natural form. Before starting the operation, carefully examine the area of ​​the pipe, assess the degree of inflammation and the level of damage. Based on what he sees, the doctor determines further surgical tactics.

As a rule, the essence of the operation is to remove hydrosalpinx, dissect adhesions and restore the lumen of the fallopian tubes. If the pipe cannot be restored, it must be removed. [adsense3]

What is the prognosis for pregnancy after laparoscopic surgery for this disease?

With the patency of the tube restored and the hydrosalpinx removed, conception naturally and pregnancy occurs in 60–75%, and the probability of an ectopic pregnancy does not exceed 5%. If the tube is removed, the effectiveness of IVF is 30 – 35%.

Are there any restrictions necessary for this disease?

Yes, definitely. Firstly, physical activity should be avoided (vibration, straining, sudden changes in body position: somersaults, bending, jumping).

Secondly, avoid excessive activity during sexual intercourse, which increases pain.

In addition, it is not recommended to sunbathe and visit a solarium, as well as visiting baths, saunas and taking hot baths, which can provoke an exacerbation of the inflammatory process.

Source: https://p-87.ru/m/gidrosalpinks/

Hydrosalpinx

Hydrosalpinx is a pathology of the fallopian tubes caused by unilateral or bilateral accumulation of transudate in their lumen. It can be asymptomatic and first detected in connection with infertility. Clinically pronounced forms of hydrosalpinx are accompanied by pain in the lower abdomen (pulling, bursting, pulsating), profuse watery leucorrhoea, febrility and general weakness. To diagnose hydrosalpinx, a gynecological examination, OMT ultrasound, USGSS and hysterosalpingography, collection and evaluation of smears, and diagnostic laparoscopy are performed. Treatment of hydrosalpinx is most often surgical - salpingostomy, tubectomy.

Hydrosalpinx is a violation of the patency of the fallopian tubes caused by the deposition of serous effusion in them. It is the most common cause of tubo-peritoneal infertility in women. The frequency of detection of hydrosalpinx in patients resorting to assisted reproductive technologies due to tubal infertility is 10-30%.

In women with hydrosalpinx, the possibility of spontaneous pregnancy is halved, embryo implantation in IVF procedures is 3-5 times less likely, and cases of miscarriage and the incidence of ectopic pregnancy are doubled.

Available statistics demonstrate the extreme relevance of this problem and the search for its solution for obstetrics and gynecology.

Classification of hydrosalpinx

Sactosalpinx is the general name for the pathology of the fallopian tubes, in which the cavity becomes encysted and filled with liquid contents. With hydrosalpinx, the contents of the saccular cavity are represented by a clear serous fluid, with pyosalpinx - pus. The pathology may have unilateral or bilateral localization.

Based on morphological features, simple and follicular (multi-chamber) hydrosalpinx are distinguished. The simple form is diagnosed when one closed cavity is formed in the fallopian tube, the follicular form is diagnosed when several cavities are formed, separated by adhesions.

In cases where the saccular cavity is periodically emptied, and its contents pour into the uterine cavity and then out, ventral (or draining) hydrosalpinx is diagnosed. The course of hydrosalpinx can be acute (active phase of inflammation) or chronic (slow inflammation).

The size of hydrosalpinx varies from one to several centimeters.

Hydrosalpinx

The transformation of the fallopian tubes into the sactosalpinx type (saktos - sac) is facilitated by the adhesive process that develops as a result of previous diseases of the pelvic organs. At the same time, connective tissue grows in the lumen of the tube, and septa form, forming pseudocysts.

The lumen of the pipe narrows to the point of complete obstruction in a certain area. Due to impaired blood and lymph circulation in the walls of the tube, transudate begins to accumulate in the formed cavity, consisting of secretions produced by the mucous membrane, blood plasma and extracellular fluid.

When the cavity is filled with transudate, the walls of the tube are significantly stretched, deformed and thinned.

The fluid may periodically pour out or be partially absorbed by the walls, but the presence of adhesions and an inflammatory reaction determines the re-formation of hydrosalpinx and the recurrent nature of the disease.

In most cases, hydrosalpinx is preceded by a local infectious-inflammatory process (salpingitis, adnexitis, endometritis), caused by both nonspecific microbial flora (including mixed infection) and STI pathogens (chlamydia, gonorrhea, mycoplasmosis, trichomoniasis, etc.). The group at increased risk for the formation of hydrosalpinx includes patients with endometriosis who have undergone reconstructive surgery on the fallopian tubes and other surgical interventions on the pelvic organs.

A small-sized hydrosalpinx with an inactive inflammatory process, as a rule, does not manifest itself in any way and is discovered by chance during a routine ultrasound of the pelvic organs.

With significant accumulation of fluid and overstretching of the tube, a feeling of heaviness in the lower lateral parts of the abdomen and chronic pelvic pain appear. Body temperature may periodically rise to subfebrile levels.

With draining hydrosalpinx, patients notice periodic discharge of copious, watery leucorrhoea from the genital tract.

In the case of acute inflammation, there is a rise in temperature to 38º-39ºC, intense bursting or throbbing pain radiating to the groin. Sometimes the clinical picture of hydrosalpinx resembles acute surgical pathology (appendicitis), intestinal or renal colic. Severe malaise, hectic fever, chills, myalgia, as a rule, indicate the development of pyosalpinx.

Impaired patency of the fallopian tubes due to hydrosalpinx directly affects reproductive function. If the lumen of the tube closes completely, this makes it impossible for the egg to enter it and fertilize - so-called tubal infertility develops.

However, even if the lumen does not close completely, damage to the ciliated epithelium, smoothness of the folds of the mucous membrane and atrophy of muscle fibers cause disruption of tube peristalsis and, as a consequence, the development of ectopic pregnancy.

Hydrosalpinx not only prevents pregnancy from occurring naturally, but also reduces the effectiveness of in vitro fertilization several times. 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, which is indicated by sudden sharp pain in the corresponding half of the abdomen, tachycardia, arterial hypotension, pale skin, and cold sweat.

In case of rupture of the pyosalpinx, there is a high probability of developing peritonitis, pelvioperitonitis, and abscess of the pouch of Douglas. In some cases, the breakthrough of pus does not occur in the abdominal cavity, but in the bladder, vagina or rectum.

Hydrosalpinx and IVF

Research in the field of reproductology convincingly proves the negative impact of hydrosalpinx on the prognosis of IVF.

At the same time, not only do the chances of successful embryo transfer decrease significantly, but the risks of developing ectopic pregnancy and spontaneous abortion in the early stages also increase.

This cause-and-effect 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” early embryos.
• Embryotoxic effect . In addition to the direct mechanical removal of embryos from the uterine cavity, the contents of the hydrosalpinx have 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 with a 50% dilution of the hydrosalpinx contents.
• Endometrial damage . Using morphological and immunohistochemical methods, pathomorphological changes in the endometrium under the conditions of the existence of hydroalpinx were identified. A decrease in local immunity, the expression of receptors for progesterone and estradiol, a decrease in subendometrial blood flow, structural disorders of the glandular and stromal components of the endometrium - any of these factors can cause a violation of embryo implantation.

Clinical, laboratory and instrumental diagnostics aimed at identifying hydrosalpinx include examination on a chair with collection of smears from the genital tract, examination of the patency of the fallopian tubes, sonography, and laparoscopy. During vaginal examination, a formation of a round or ovoid shape of a tight-elastic consistency, usually moderately painful, may be palpated between the uterus and the ovary.

Transvaginal or combined gynecological ultrasound complements and clarifies the data of a gynecological examination.

Echographic visualization of dilated, elongated fallopian tubes with homogeneous (with hydrosalpinx) or heterogeneous (with pyosalpinx) contents. An intact ovary is identified next to the thickened tube.

The most reliable data for the presence of hydrosalpinx can be obtained during diagnostic laparoscopy. At the same time, the monitor shows thickened fallopian tubes with edematous fimbriae, thinned walls of the tube, through which the watery contents are visible. Laparoscopy is also the main component of conservative-surgical management of patients with hydrosalpinx.

It is not possible to cure hydrosalpinx only by conservative means. The preservation of pathomorphological prerequisites for the accumulation of transudate determines the recurrent course of the pathology. In addition, the presence of hydrosalpinx casts doubt on the successful implementation of reproductive plans.

Currently, all patients with this problem undergo two-stage treatment. First, adequate anti-inflammatory therapy is prescribed, aimed at stopping the activity of the infectious process in the fallopian tubes.

Antibacterial drugs, vitamin therapy, and physical therapy (electrophoresis, magnetophoresis, laser phoresis) are prescribed.

At the surgical stage, preference is given to laparoscopic techniques.

Depending on the location and severity of pathological changes, various reconstructive interventions on the fallopian tubes can be performed (salpingo-ovariolysis, fimbryolysis, salpingostomy or salpingoneostomy). In the postoperative period, mud therapy, balneotherapy, and electrical stimulation of the fallopian tubes are performed.

However, even the elimination of adhesions and reocclusion of the tubes is not a guarantee of spontaneous pregnancy, since it is not always possible to restore full peristaltic activity of the fallopian tubes.

Removing the fallopian tube increases the effectiveness of an IVF program three or more times.

Forecast and prevention of hydrosalpinx

Hydrosalpinx is associated with low chances of pregnancy, both when trying to conceive independently and as part of IVF protocols. Functional reconstructive surgery does not always allow achieving the desired pregnancy naturally, so the method of choice for a significant proportion of patients is tubectomy followed by an IVF cycle (.

Prevention of hydrosalpinx is the prevention and adequate treatment of PID (salpingoophoritis, endometritis) and STDs, exclusion of casual sexual contacts, refusal of abortions, regular observation by a gynecologist.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_gynaecology/hydrosalpinx