What is hydrosalpinx. How is tubal hydrosalpinx treated? indications for surgery. How to treat hydrosalpinx: can the disease go away on its own

- This is a disease of the fallopian tubes, in which the patency is disturbed and fluid accumulates in the lumen of the tube. This pathology is provoked by an adhesive process in the small pelvis.

Hydrosalpinx leads to scarring and adhesions. The muscular coat at the same time loses the ability to contract. Fluid begins to accumulate in the fallopian tube, which is prone to inflammation.

In the absence of adequate treatment, the disease leads to complications, which include infertility, and in case of a successful pregnancy, the threat of miscarriage and spontaneous abortion.

Symptoms of hydrosalpinx

Depending on the number of cavities in the tube, a simple and follicular form of the disease is distinguished. There are also acute and chronic forms of the disease, each of which has characteristic symptoms.

Acute symptoms

Acute hydrosalpinx is characterized by the production of serous exudate in the tube and the following symptoms:

• bursting throbbing pain in the groin area;
• fever (38-39 degrees Celsius);
• heartbeat quickens;
• weakness;
• there is a strong blush on the cheeks.

Symptoms of the chronic form

Chronic hydrosalpinx develops slowly, characterized by gradual gluing of the fimbriae of the fallopian tube and the accumulation of exudate in the cavity of the tube. As a rule, there are no pain sensations, and the pathology is accidentally detected during an ultrasound scan of the pelvic organs.

With the accumulation of mucus, there is a feeling of a foreign body in the inguinal region and a feeling of heaviness. There is no rise in body temperature. Periodically there are pelvic pains.

With "valve" hydrosalpinx, adhesions are not dense, sometimes they break through with a stream of mucus, periodically emptying the tube. This form of pathology is characterized by periodic abundant watery discharge.

Treatment of hydrosalpinx

There are two methods of treating hydrosalpinx:

• conservative treatment;
• surgical intervention.

Conservative treatment is to eliminate the inflammation that led to the damage to the tubes. Combined with bacterial and physiotherapy. These methods prevent the aggravation of the disease and act as maintenance therapy if a woman has a hydrosalpinx on the right or left. But the irreversible process that occurs in the fallopian tubes is not eliminated.

Surgical treatment

Types of operations on the fallopian tubes:

• salpingo-ovariolysis;
• salpingostomy;
• laparoscopy.

Before considering each type, we note that surgery is acceptable for women under 35 years of age. Otherwise, the fallopian tubes are removed, because the inflammatory processes in them will interfere with the normal implantation of the egg.

Salpingo-ovariolysis

Salpingo-ovariolysis is a type of surgical intervention, the main purpose of which is the dissection of adhesions that fix and (or) cover the fallopian tube, ovary. Those spikes that isolate these organs are also operated, not allowing them to interact.

Salpingostomy

A salpingostomy is an operation that creates an opening in the fallopian (fallopian) tubes. Through this hole, the fallopian tube is connected to the abdominal cavity.

Studies have shown that in the treatment of hydrosalpinx by these methods, pregnancy occurs only in 10-20% of cases. The reason is that the created holes overgrow after a while.

Laparoscopy

Therefore, laparoscopy is preferable, the purpose of which is to restore patency by separating adhesions both in the fallopian tube and around it. Laparoscopy does not interfere so much with the structure of the fallopian tubes, and therefore, if successful, the likelihood of becoming pregnant increases significantly.

A successful laparoscopy does not mean a complete restoration of the functions of the fallopian tubes: the villi of the mucosa are no longer so mobile, and the muscle sheath is no longer so reduced. This increases the risk of an ectopic pregnancy.

If laparoscopy does not bring the desired result, then the fallopian tubes are removed. They are a source of infection in a woman's body and do not perform their intended functions. In this case, pregnancy is possible only with the help of ART.

Which doctors to contact with hydrosalpinx

Folk remedies for the treatment of hydrosalpinx

As an additional treatment, folk remedies are used.

Bilateral hydrosalpinx

The fallopian tubes, as you know, are a paired tubular organ, a hollow two-lumen tube that starts from the uterine cavity and ends with fimbriae (fringe) that capture the egg. The fallopian tubes are located on both sides of the fundus of the uterus.

Thus, with bilateral hydrosalpinx, fluid accumulation occurs in both the left and right parts. In this case, conception in a natural way is impossible.

However, unilateral hydrosalpinx is much more common in women. Despite this, inflammation occurs in both fallopian tubes, which reduces the chances of getting pregnant.

Causes of hydrosalpinx

The origin of the fluid in the lumen of the fallopian tube is non-inflammatory. The fluid consists of blood plasma that seeps through the walls of blood vessels, extracellular fluid, and the tubes' own natural secretions.

Accumulation occurs because there is no exit of fluid to the outside due to the complete overlap or narrowing of the lumen of the fallopian tube, as well as impaired blood circulation in the walls of the tubes.

Narrowing and overlapping of the lumen of the fallopian tubes are caused by past inflammation of the uterine appendages (adnexitis). After this inflammatory process, the lumen may become completely blocked or remain partially passable. In areas of the fallopian tube, adhesions appear that limit this area.

Follicular hydrosalpinx is a hydrosalpinx that develops in the presence of several such overlapped areas and consists of cavities. If the adhesions partially overlap the fallopian tube, then the hydrosalpinx cavities can be emptied from time to time, which causes cyclical symptoms.

Risk factors

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 anomalies in the structure of the pelvic organs;
• violation of lymph circulation;
• inflammation of the fallopian tubes;
• previous inflammatory processes of the organs of the reproductive system;
• infections and sexually transmitted diseases;
• bowel disease.

Hydrosalpinx and pregnancy

Before pregnancy, removal of cysts is recommended, because the fluid they contain has a toxic effect on the embryo, disrupting its development up to miscarriage or non-carrying. Greater risk of ectopic pregnancy.

Diagnosis of hydrosalpinx

The following methods of diagnosing hydrosalpinx are used:

Prevention of hydrosalpinx

Among the preventive measures it is worth highlighting:

• treatment of gynecological diseases;
• regular monitoring by a gynecologist;
• compliance with the rules of personal hygiene;
• healthy lifestyle;
• avoidance of casual sexual contacts.

Questions and answers on the topic "Hydrosalpinx"

Question:Hello, I have hydrosalpinx on the right side, but the left tube is passable, but there has been no pregnancy for 4 years now, can the hydrosalpinx of the right side affect the passable tube of the left side, why is there no pregnancy, is it necessary to remove it.

Answer: The probability of pregnancy with unilateral hydrosalpinx is halved. Surgery increases the chances of getting pregnant and reduces the risk of ectopic pregnancy. In addition, it would not be superfluous to check the husband (spermogram).

Question:Hello! I was diagnosed with left saltospinx for 2 years. She underwent several ultrasounds, which showed a saltospinx on the left. I went for laparoscopic surgery - they removed the right appendages. How can this be? But the pain on the left does not go away. I am 58 years old.

Answer: Hello! This question should be asked to the attending physician, surgeon and their management. Or directly to RosMinZdrav: hotline 8 800 200-03-89.

Question:Hello! I was diagnosed with bilateral hydrosalpinx. Now I am undergoing IVF examinations, the doctor did not say anything. Is IVF done with such a diagnosis? Maybe they just brush me off.

Answer: Hello! In connection with the widespread use of IVF, there have been many reports indicating a significant number of cases of procedure failure in women with hydrosalpinx. The frequency of implantation of a fertilized egg, development of the embryo and pregnancy in them is 2-5 times lower than in women with other causes of infertility. In most cases, reproductive specialists advise IVF and, as a preparatory stage, surgical salpingectomy (removal of the pathological fallopian tube), after which the probability of pregnancy as a result of IVF increases by more than 2 times. Internally consult at the reproductologist.

Question:Hello! I am 24 years old, I am undergoing examination before planning a pregnancy. In September, I stopped drinking OK Lindinet 20. In the second cycle, after the cancellation, an ultrasound scan was performed on the 19th day of the cycle, according to its results: Pathological formations in the small pelvis: a two-dimensional anechoic formation in the region of the right appendages measuring 16x11 mm. Everything else is fine, there is a dominant follicle in the right ovary. The ultrasound doctor makes a diagnosis: the ultrasound picture corresponds to the periovulatory phase of the cycle, possibly hydrosalpinx! Where did I get it from? Just a month ago I was at the doctor’s appointment, and before that I was constantly examined and did an ultrasound scan, this has never happened! And is it possible that the ultrasound doctor confused this hydrosalpinx with a paraovarian cyst on the right of about the same size that I was found about 3 years ago on several ultrasounds in a row (done in another clinic). And how can this be cured, because I'm planning a pregnancy?

Answer: Hello! Hydrosalpinx is a disease of the fallopian tubes, characterized by a violation of their patency with the accumulation of fluid in the lumen of the tube. The fluid in the lumen of the tube with hydrosalpinx is of non-inflammatory origin. It is a blood plasma that sweats through the walls of blood vessels, extracellular fluid and the natural secret of the fallopian tubes, which accumulate in the cavity of the tube due to the impossibility of emptying it. The direct mechanisms that cause the development of hydrosalpinx are narrowing or complete blockage of the lumen of the fallopian tube and impaired blood circulation in its wall. Your question about the fact that the doctor may have taken a paraovarian cyst for a hydrosalpinx is fair. To clarify the diagnosis, I recommend repeating the ultrasound on the 5th day of the menstrual cycle. You should also contact a gynecologist to resolve the necessary issues related to pregnancy planning.

Question:Hello, tell me, can hydrosalpinx disappear without treatment? From the beginning of December, it was visible on ultrasound (in February and March, too), there was supposed to be an operation, today they did a control ultrasound and there was nothing (they did it there). Can it reappear?

Answer: Hello! During treatment, the fluid may disappear, but it is not a fact that the anatomy of the fallopian tube has recovered. Be sure to check the patency of the fallopian tubes.

Many girls or women, as they grow older, want more and more to become mothers, but for unclear reasons, pregnancy still does not occur. Or the female gender may be disturbed by a slight discomfort in the pelvic area. Is everything safe? Often, the absence of pregnancy or the pulling lower abdomen are a sign of hydrosalpinx.

What it is?

Hydrosalpinx is a pathology of the female genital organs, which is characterized by the accumulation of fluid in the cavity of one or both fallopian tubes, which in turn leads to a violation of the patency of the tube itself. The liquid is mostly transparent. This condition is one of the main causes of the development of female infertility of the tubal-peritoneal form.

Hydrosalpinx - video

What are the fallopian tubes and what are they for?

In another way, the fallopian tubes are called fallopian tubes. They are hollow cylinders, one end of which is connected to the uterine cavity, and the other ends with fimbriae opening into the abdominal cavity. The pipes have several sections. These are the interstitial section, the isthmus and the ampullar section, which ends with the funnel of the fallopian tube. The main function of the fallopian tube is to create optimal conditions for the fertilization of the egg and its subsequent transport to the uterine cavity.

Classification

There are several options for classifying hydrosalpinx. Depending on the location of the lesion, it can be:

• unilateral;
• bilateral.

Depending on the morphological features, there are:

1. Simple hydrosalpinx. In this case, one cavity is formed in the lumen of the pipe.
2. Follicular (multi-chamber) hydrosalpinx. With this form, the cavity is divided into several parts due to the formation of adhesions (septa).
3. Ventilated (draining) hydrosalpinx. In this variant of the pathology, periodic emptying occurs with the outflow of contents into the uterine cavity and further through the vagina to the outside.

Regarding the course of the disease, there are:

• acute course - the active phase of inflammation;
• chronic course - sluggish inflammation.

Causes of hydrosalpinx development

1. Local infectious and inflammatory process.
2. Surgical interventions on the pelvic organs.
3. Ectopic pregnancy.

All these reasons lead to the fact that the connective tissue grows inside the tube, adhesions are formed. Subsequently, due to circulatory disorders, fluid accumulates in the cavity of the tube, which leads to the formation of a hydrosalpinx.

Predisposing factors

1. Various disorders in the endocrine system, such as diabetes mellitus or thyroid pathology.
2. A large number of experiences and other situations associated with stress.
3. Careless attitude to personal hygiene.

How is hydrosalpinx manifested?

Unfortunately, quite often this pathology does not manifest itself in any way, and if there are any symptoms, they are rather non-specific and uninformative. Often, women come to a gynecologist for a consultation only because they are unable to conceive a child. What symptoms may appear:

• flaccid, pulling, bursting, aching pain in the lower pelvis. However, if there is a significant stretching of the pipe, or even worse, its rupture, then the development of the so-called "acute abdomen" is possible. The pain will become sharp, acute, a rise in temperature is possible;
• watery discharge from the vagina, which is possible with a ventilated form of the disease;
• general weakness, apathy, asthenia;
• history of infertility.

Diagnostics

There are several stages in the diagnosis of this pathology.

1. First, it is necessary to carefully collect an anamnesis from a woman. Since often there will be no complaints, and during the interview, the doctor finds out that in the past the patient had various inflammatory diseases of the pelvic organs or some kind of surgical intervention. It is also possible that a woman will complain about the lack of pregnancy, despite repeated attempts to conceive a baby.
2. Secondly, you need to conduct a gynecological examination of the patient. It is possible to determine a dense elastic band between the body of the uterus and the ovary.
3. Third, ultrasound. With this type of examination, the specialist will detect stretching of the pipes, an increase in their cavity, which is not normal.
4. Fourth, hysterosalpingography is performed. With this diagnosis, a contrast agent is injected into the uterine cavity, and then a picture is taken on an x-ray machine. You will also see the expansion of the cavity of the fallopian tubes.
5. Fifth, it is possible to perform laparoscopy. When performing this procedure, a transition from diagnostic measures to therapeutic measures is possible.

Differential Diagnosis

Hydrosalpinx should be differentiated from various diseases that can cause certain symptoms. A similar clinical picture may have:

• inflammation of the appendix (appendicitis);
• neoplasms of the pelvic organs;
• inflammatory diseases of the pelvic organs.

Treatment

If a woman is diagnosed with a similar disease, then it is necessary to take timely and high-quality therapeutic measures. The lack of symptoms of the disease should not mislead a woman, as it can lead to disastrous consequences. Among the methods of treatment of hydrosalpinx, the following can be distinguished:

• drug treatment;
• treatment with physiotherapeutic methods;
• surgical intervention;
• lifestyle change.

Medical treatment

This type of therapy is the first choice. However, it should be borne in mind that conservative therapy must be prescribed under certain conditions, so surgical treatment is the main one in the treatment of this pathology. Here you can use the following groups of drugs.

1. Antibiotics. This group of drugs should be prescribed strictly individually. Before using a woman, it is worth taking a smear for the sensitivity of microflora and then purposefully use medications. Antibiotics are mainly directed against pathogens of infectious diseases of the pelvic organs. Broad-spectrum drugs can be used. It can be:
   • penicillin series (Ampicillin, Amoxicillin);
   • cephalosporin series (Cefalexin, Keflex);
   • macrolides (erythromycin, azithromycin);
   • tetracycline series (Tetracycline, Doxycycline).
2. Non-steroidal anti-inflammatory drugs. This group of drugs has an analgesic effect, as well as relieve inflammation and lower the temperature. It is possible to use the following drugs:
   • Paracetamol.
   • Ibuprofen.
   • Nimesulide.
3. Antimycotics. These drugs are aimed at suppressing the fungal infection. Here you can use the following tools:
   1. Miconazole.
   2. Clotrimazole.
4. Drugs for dysbacteriosis. It is possible to use drugs that will counteract the occurrence of intestinal dysbacteriosis when taking antibiotics. It can be:
   • Bifiform.
   • Acipol.
   • Probifor.
5. Immunomodulatory drugs. This group of medicines is aimed at strengthening the entire immune system of a woman. It is possible to use the following drugs:
   • Polyoxidonium.
   • Immunofan.
6. local medical therapy. Often, various drugs are used to relieve local inflammatory processes through a swab or in the form of suppositories. They may be:
   1. Longaridase.
   2. Ichthyol ointment.
   3. Vishnevsky ointment.
   4. Levomekol.

Drug therapy - gallery

Ampicillin is a broad-spectrum antibiotic and is aimed at destroying the bacterial flora of the urinary tract.
Reduces temperature, has an analgesic and anti-inflammatory effect Fights fungal infection
Helps reduce the risk of dysbacteriosis Improves nonspecific immunity Used as a topical treatment

Physiotherapy as a treatment for hydrosalpinx

It is used as an additional method in combination with drugs. In sum, this allows you to improve the well-being of a sick woman. For this, several methods are used.

1. Electrophoresis with drugs. Depending on the patient's well-being, the doctor can prescribe various procedures for her. Together with it, various medicinal substances can be used that have an anti-inflammatory, analgesic effect.
2. Ultraphonophoresis. The effect of ultrasound on body tissues is used. This procedure improves local blood flow and has an analgesic effect.
3. Magnetophoresis. In this case, the influence of a low-frequency magnetic field on the body is used. It also involves the administration of medications.
4. Magnetotherapy. Improves trophism, reduces pain, provides blood supply to tissues.
5. Massotherapy. Helps improve blood flow in damaged tissues.
6. Darsonvalization. This procedure improves local immunity, increases blood circulation, has anti-inflammatory and anti-edematous properties.
7. Hirudotherapy. It is possible to use this method, but at the moment there is no reliable evidence in favor or absence of the latter.

Surgery

Surgical treatment is by far the main and most effective method of treating hydrosalpinx. To date, there are many methods of treatment of this pathology.

Hydrosalpinx puncture

In this case, fluid is aspirated from the inflamed section of the tube. The puncture is performed transvaginally, after which the liquid is pumped out.

Salpingo-ovariolysis (laparoscopy)

With the help of laparoscopic access, a specialist dissects adhesions both in the small pelvis and directly in the cavity of the tubes. Today it is the main method of surgical intervention.

tubectomy

During this operation, the tube is surgically removed. This method is used in cases where other methods of therapy have not shown proper effectiveness. When the tube is removed, the possibility of pregnancy is significantly reduced. If both tubes are removed, then natural fertilization is, in principle, impossible. In this case, the only way out for the spouses will be in vitro fertilization (IVF).

Lifestyle change

1. First, a woman should give up intense physical activity. She herself must choose those exercises that do not cause her pain or discomfort.
2. Secondly, the patient should take care of his immunity, namely to strengthen it. To do this, you can not do without proper nutrition. Attention should be paid to products containing a large amount of vitamins and polyunsaturated fatty acids. It can be fresh vegetables, fruits, wholemeal cereals.

Treatment prognosis and possible complications

With well-conducted therapeutic measures, a complete cure for this pathology is possible, which, subsequently, will help a woman conceive a child.

If, for whatever reason, there was a need to remove the tube, then in this case the woman should resort to in vitro fertilization (IVF).

Possible Complications

In the absence of competent treatment, the process may worsen, which can lead to rather disastrous consequences. It can be:

• menstrual irregularities of a different nature;
• vaginal dysbacteriosis;
• kinks of the body of the uterus;
• ectopic pregnancy;
• various intestinal obstruction;
• pyosalpinx, which occurs when an infectious agent is attached;
• various forms of female infertility;
• rupture of the fallopian tubes;
• frequent miscarriages;
• inflammation of the peritoneum.

The disease can manifest itself acutely or proceed sluggishly with remissions and relapses.

It affects one pipe or both at the same time. The cavity filled with transudate is one or it is divided by partitions into several chambers. The diameter of the pipe increases from a few millimeters to several centimeters, the walls become thinner. As a result of circulatory disorders, edema of the fimbriae occurs.

The main complication of hydrosalpinx is infertility, which is caused not only by impaired patency of the oviduct, but also by a constantly maintained inflammatory process that prevents implantation of the embryo, causes damage incompatible with life and miscarriages in early pregnancy.

Treatment of hydrosalpinx is carried out in a conservative or more effective surgical way. If it is impossible to fully restore the functionality of the oviduct, relapse, for the prevention of complications, tubectomy is recommended in many cases.

Hydrosalpinx classification

Causes of hydrosalpinx

The cause of hydrosalpinx is often adhesions formed as a result of inflammatory processes. They prevent the normal outflow from it of the secret produced by the mucosa. Fluid may also accumulate as a result of sweating into the cavity of the tube from the extracellular space and small vessels.

Adhesions can be located in the abdominal cavity or inside the oviduct. The adhesive process in the abdominal cavity occurs after surgical interventions for various diseases of the internal organs, for example, after appendicitis, peritonitis of various etiologies. The cause of the adhesive process can be inflammation of the appendages, endometriosis and other female diseases.

Adhesions in the fallopian tube are formed during inflammatory processes of an infectious and non-infectious nature. Their formation occurs gradually, therefore, at some stage, when adhesions do not completely block the lumen of the pipe, the fluid accumulating in it can be periodically emptied. This is the so-called valve form, it is characterized by periodic abundant mucous secretions.

The causes of hydrosalpinx are inflammatory processes in the genital or nearby organs, causing an adhesive process. These can be infectious diseases, STDs caused by specific and nonspecific microflora.

The inflammatory process is usually localized in the uterus (endometritis), ovaries, appendages (adnexitis) or in the abdominal cavity (appendicitis). Often the disease is provoked by abortions, diagnostic curettage, surgical interventions on the pelvic and abdominal organs.

Violation of the outflow of fluid can occur when neoplasms form in the oviduct, which, increasing in size, block its lumen. Therefore, during the examination, it is necessary to carry out differential diagnostics with oncopathology.

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Signs and symptoms of hydrosalpinx

Usually the disease is asymptomatic. A small amount of transudate can cause nagging pain in the pelvic area on the one hand, heaviness. Since the fluid gradually stretches the walls of the oviduct, complaints of severe pain are rare. It can appear during sex, while performing some physical exercises.

Sharp pains on the one hand, accompanied by increased heart rate, cold sweat indicate a rupture of the tube, and the emptying of the contents into the abdominal cavity. Unlike pyosalpinx, the diagnosis of hydrosalpinx does not always develop peritonitis, but the likelihood of bleeding from their damaged tube is high.

More often there is a valve form, in which the fluid is emptied into the lumen of the uterus. At the same time, the woman has abundant leucorrhoea (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 contributes to 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:

• pulling pains in the lower abdomen, they can be aggravated during sexual intercourse;
• mucous secretions;
• difficulty conceiving.

Often a woman does not feel any discomfort, and the pathology is detected when she consults a doctor about infertility. Hydrosalpinx is one of the causes of tubal infertility. Moreover, infertility in this pathology can be associated not only with the patency of the tubes. Periodic abundant emptying of the transudate can physically “wash away” the blastocyst, which is especially important if a woman, due to infertility, decided to turn to 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 IVF, in order to reduce the risk of unsuccessful procedures, it is recommended to do a laparoscopic tubectomy in advance.

Symptoms of hydrosalpinx usually appear against the background of chronic salpingitis, and during exacerbations can lead to suppuration of the effusion, the formation of pus, pyosalpinx, and subsequently to peritonitis.

If, with hydrosalpinx, an increase in body temperature is short-term, does not exceed 37.4-37.7 degrees Celsius, then pyosalpinx is characterized by fever, increased heart rate, and weakness. The consequences of pyosalpinx are very dangerous, therefore, if such symptoms are detected, a visit to the doctor cannot be postponed.

Diagnosis of hydrosalpinx

Often, hydrosalpinx is detected during a routine examination or an appeal to a gynecologist about infertility. Only during the examination, the doctor can detect a painful and rounded or oval formation in the oviduct. It is possible to clarify the diagnosis and differentiate the expanded tube from other pathologies during instrumental examination.

Diagnosis of hydrosalpinx includes:

• gynecological examination;
• examination of vaginal discharge (smear);
• ultrasonography;
• hysterosalpingography;
• diagnostic laparoscopy.

Ultrasound scanning can be performed both by the percutaneous abdominal method and by the vaginal method. When examining between the uterus and the ovary, an expanded fallopian tube with homogeneous contents is clearly visible. With pyosalpinx, it has a heterogeneous character.

To check the patency of the pipes, hysterosalpingography is performed. Moreover, it should be remembered that the formation of hydrosalpinx can be a symptom of cancer of the fallopian tube. Therefore, when it is detected, you need to be careful and conduct additional diagnostics for cytology.

Diagnosis of hydrosalpinx using laparoscopy is not only a diagnostic, but also a therapeutic method. On examination, enlarged oviducts with thinned walls are revealed. The fimbriae are usually edematous. During laparoscopy, it is possible to dissect adhesions surrounding the oviduct and ovaries, due to which the physiological position of the tube is changed, to impose a stoma (hole for the outflow of fluid) in order to continue treatment in a conservative way.

Treatment of hydrosalpinx

If a woman is diagnosed with hydrosalpinx, its treatment requires surgical intervention, which is performed by laparoscopy or laparotomy. It is necessary to dissect 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 more preferable because it has the following advantages:

• Minimally invasive and low-traumatic operation. Three small incisions are made through which endoscopic equipment is inserted and the altered oviduct is removed.
• Rapid recovery after surgery, already 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.

In order to prevent the formation of adhesions, patients are raised early, bed rest is indicated only in the first hours after the operation, while the patient leaves after anesthesia. Then they are allowed to sit, get up, walk under the supervision of medical staff or caregivers.

After the operation, conservative treatment is prescribed, which includes:

• antibiotic therapy;
• anti-inflammatory substances;
• painkillers;
• dissolving drugs.

Physiotherapy shows good efficiency, prescribe:

• electrophoresis;
• laser phoresis;
• magnetotherapy;
• electrical stimulation of the fallopian tubes;
• balneotherapy;
• mud treatment.

It is rather difficult to restore the patency of the tube, since even after getting rid of adhesions, it is not always possible to achieve a complete restoration of the ciliated epithelium, due 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 changed tube during the treatment of hydrosalpinx.

The probability of getting pregnant with one tube with a unilateral process remains, but if both tubes are affected, the risk of developing an ectopic pregnancy is high, which is dangerous for a woman. Experts recommend using assisted reproductive technologies for infertility against the background of hydrosalpinx. But at the same time, it is necessary to do a tubectomy, since the changed tubes are a source of infection, maintain inflammation of the endometrium, and reduce the chances of getting pregnant with IVF.

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What is Hydrosalpinx? This question arises in almost all women who have been given such a tricky diagnosis. If we leave complex medical terms, then otherwise we can say that this is dropsy of the fallopian tube (oviduct). Yes, yes, a bag of liquid has formed on the pipe, the size of which varies considerably.

Sometimes, after the removal of a pathological formation, a woman is shown simply a huge "bubble" with a cloudy liquid, reaching the size of a small children's ball. The female reproductive system is a fairly complex and precise structure that, in its normal state, provides ideal conditions for the conception of a new life.

Oviducts got their name for a reason. They are the real path along which the egg or zygote (recently born fetus) “goes” into the uterine cavity. And what if this path suddenly became impassable? Then pregnancy becomes impossible, and doctors are forced to make a terrible diagnosis for a woman - Infertility. When making this diagnosis, the ICD code - 10 - N70.1 is prescribed in the medical history.

Chronic hydrosalpinx

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 proceeds almost imperceptibly, causing irreparable harm to the woman's reproductive system. The constant presence of inflammation and exudate disrupts the functioning of the fallopian tubes. They lose their ability to contract and elasticity.

But the biggest pathological changes concern the ciliated layer of the oviduct. Cilia, 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 movement. But when dropsy occurs, the cilia stick together, and therefore their natural function is disturbed.

Bilateral hydrosalpinx in our time is increasingly common. Such a diagnosis suggests that the oviducts are affected on both sides (Hydrosalpinx on the right, on the left). Bilateral damage to the reproductive system dramatically worsens treatment prognosis and increases the risk of infertility. According to statistics, right-sided and left-sided lesions of the fallopian tubes occur with the same frequency.

What is valve hydrosalpinx

It happens that the adhesion blocks the oviduct, but the connective tissue has a softer, pliable consistency. As fluid accumulates in the pipe, the pressure inside the cavity increases many times over, which leads to overstretching of the walls.

The liquid begins to press on the connective tissue with such force that the adhesion does not withstand, and the possibility of outflow of exudate is formed, which breaks either into the uterine cavity or into the abdominal cavity.

All of the above occurs with valve hydrosalpinx! The fallopian tube acquires partial patency, which in many cases helps a woman become pregnant. Hundreds of cases have been documented where women became mothers even with the huge size of dropsy.

But a fluid breakthrough can also cause irreparable harm, especially when using IVF (in vitro fertilization). An embryo conceived outside a woman's body and then transferred into her uterus can simply be washed away by the outflow of exudate. Thus, all the efforts of reproductive specialists (doctors for artificial insemination) fail. That is why, more and more often, before conception “in vitro”, it is recommended to surgically remove dropsy of the fallopian tube.

Causes of Hydroalpinx

The mechanism of the onset of the disease has not been fully studied, but the causes of Hydrosalpinx include:

• congenital abnormal development of the organs of the reproductive system;
• violation of the movement of lymph along the lymphatic pathways;
• abdominal operations;
• previous ectopic pregnancy;
• pathological growth of the endometrium;
• perforated appendicitis;
• adhesive disease in the pelvic area;
• circulatory disorders and / or chronic foci of inflammation in the reproductive organs;
• previous sexually transmitted diseases, especially Chlamydia and Gonorrhea;
• some intestinal pathologies.

The causes of bilateral hydrosalpinx are identical to the above points.

Symptoms of Hydrosalpinx

Symptoms of Hydrosalpinx are very diverse. These include:

• watery vaginal discharge. They may be cloudy or have a serous-purulent structure;
• drawing pains in the area of ​​projection of the appendages. Their intensity is moderate;
• with an exacerbation of the disease, women note a rather sharp rise in temperature to 39 g. Celsius.

Much less common is a prolonged rise in temperature, unexplained weakness, fatigue, poor general health, depressive, difficult to treat psychological conditions. These signs are identical for both the Hydrosalpinx on the right and on the left.

All signs of Hydrosalpinx can manifest themselves with varying degrees of intensity, which increases the risk of misdiagnosis or belated diagnosis. Sometimes the woman herself delays the gynecological consultation, only aggravating her situation.

What is the danger of the disease

Consequences of Hydrosalpings:

• primary or secondary infertility;
• ectopic pregnancy;
• rupture (perforation) of the oviduct with internal bleeding;
• accession of infection and suppuration of exudate.

Differential Diagnosis

Today, various methods of differential diagnosis of the disease are available. These include:

• Ultrasound (ultrasound examination). Hydrosalpinx on ultrasound looks like a liquid pathological inclusion, localized in the space between the ovary and the uterus itself. Such an echo sign is a decisive factor in making this diagnosis;
• gynecological examination;
• hysterosalpingography (hydrosalpingography (HSG);
• laparoscopy. It should be noted that carrying out laparoscopy Hydrosalpinx can not only be identified, but also cured.

Conservative treatment

Treatment without surgery is the first step towards getting rid of the disease. To combat the inflammatory process, broad-spectrum antibiotic treatment is used. Such drugs are prescribed not only in injections, but also in tablets and suppositories, which only simplifies treatment. Be sure to prescribe Longidaza, as a drug ideal for the treatment of this disease.

To mobilize the body's own forces, general strengthening, vitamin, absorbable preparations and medicines are additionally prescribed that remove excess fluid from the tissues. The action of drugs is enhanced by physiotherapy 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, which will certainly benefit in this disease. After all, if the fallopian tubes restore patency, then the likelihood of pregnancy will increase many times over.

Homeopathy is another auxiliary method of treating the disease. The benefits of taking homeopathic medicines are highly controversial, have no evidence base and are not accepted by official medicine. But, after a detailed consultation with a specialist, you can try this method of defeating the disease.

On the forms of those women who cured the disease, more and more often you can find positive reviews about the treatment with leeches. Even wise Chinese healers 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 undeservedly forgotten, but today it is experiencing a real “boom” in popularity.

For a long time, this pathology was treated with propolis. For the preparation of tinctures, only high-quality raw materials are used or they are bought ready-made in a pharmacy. For home cooking, they take medical alcohol (60%) and mix it with crushed propolis (40%). Use tincture for rubbing the skin of the abdomen on the affected side.

In folk medicine, decoctions of anti-inflammatory herbs are used as medicinal microclysters. Juice treatment is actively used, which is combined with clay treatment.

It should be remembered that traditional medicine cannot become the main treatment even if a mild degree of this pathology is detected. Folk remedies are just an addition to complex treatment!

Treatment of hydrosalpinx disease with surgery

Sometimes it happens that the treatment of Hydrosalpinx can only be continued by surgical intervention - removal of dropsy. When removing Hydrosalpinx, a sparing technique is most often used - laparoscopy.

It requires the latest optical technique, through which dropsy is removed without abdominal opening of the abdominal cavity, which minimizes the risk of postoperative complications, reduces the likelihood of adhesions and bleeding, and does not bring serious cosmetic defects.

After the stage of dropsy removal, the surgeon performs plastic surgery of the oviduct, restores its patency, excised adhesive scars and restores re. Laparoscopy of Hydrosalpinx has a number of contraindications, which the gynecologist treating you will definitely warn about.

Some women suffer from a real phobia that prevents them from having an operation on time and gaining the joy of motherhood. In such cases, a competent gynecologist will definitely advise you to visit thematic forums where you can easily communicate with those people who have overcome identical problems.

On such sites, you can see photos and listen to videos about the stages of surgery, get acquainted with the symptoms and duration of the postoperative period, find out the rate of laboratory tests. But if fear remains an insurmountable obstacle, then, without hesitation, you should go to a professional psychologist.

Conclusion

As you can see, Gidrosalpinsk is a serious illness, therefore, disease prevention should be dealt with immediately after the birth of a girl. It is the responsibility of parents to teach a girl or teenager to take good care of their health. The child must be aware of the importance of reproductive health, so by all means convey useful information to him. The woman comes from childhood. And if childhood and adolescence passed in compliance with all the rules for preventing the disease, then the risk of acquiring pathology already in adulthood is reduced significantly.

The most interesting on the topic

Is it possible to treat hydrosalpinx without surgery? Will there be an effect or is it worth resorting to surgical intervention? Many women are terribly frightened when, having come to a regular routine examination to a gynecologist, they suddenly hear a scary-sounding diagnosis: hydrosalpinx on the right or left. What is it and what can be advised in such a situation? First of all, don't panic.

Causes and symptoms of hydrosalpinx

Hydrosalpinx is an ailment that disrupts the patency of the fallopian tubes. What are the causes of hydrosalpinx? The disease occurs against the background of a previous inflammatory process in the fallopian tubes, transferred without appropriate treatment.

A fluid forms in the tubule of the tube, which blocks the lumen. From this point on, the chances of a woman becoming a mother are significantly reduced.

Then, as the disease develops, the first symptoms of hydrosalpinx of the fallopian tubes appear: aching pains in the lower abdomen. Periodically, the body temperature rises for no reason. Emergence appears, which until this moment was not.

All these symptoms can be manifestations of a variety of diseases, therefore, to clarify the diagnosis, it is necessary to conduct an appropriate examination.

Almost the same signs have a tumor located between the uterus and the ovary. Therefore, upon examination, the gynecologist first of all excludes this particular disease, and only then the question arises about the presence of signs of hydrosalpinx.

The pathological process can spread to both one and two pipes. When the disease is advanced, the pipes are completely sealed.

How to treat hydrosalpinx

Now let's figure out how hydrosalpinx is treated. Doctors usually advocate a conservative way to treat the fallopian tubes. The second way is operational. It is considered more effective, but can lead to various complications.
Conservative treatment of hydrosalpinx is longer in time, requires considerable effort and patience.

But in the end, it leads to the restoration of the fallopian tubes without any threat to reproductive function. This means that a woman who has undergone hydrosalpinx will be able to give birth to a child without any problems. While during the surgical intervention, the pipes may be damaged, and then it will no longer be possible to become a mother in a natural way.

Therefore, it is not surprising that most women who are diagnosed with hydrosalpinx on the right or hydrosalpinx on the left or bilateral hydrosalpinx choose conservative treatment. But here it is definitely worth mentioning that drug therapy is possible only with a mild form of the disease.

In more severe cases, you will have to agree to the operation. The problem lies in the fact that at the initial stage the disease goes unnoticed by the woman. She does not feel any changes in her condition, and the pathology is detected by chance during a routine examination.

Treatment of hydrosalpinx without surgery

How is hydrosalpinx treated without surgery? First of all, it is worth remembering that the inflammatory process is at the origin of the disease.

Therefore, treatment should begin with antibiotics.

The dose and the drug itself are selected by the doctor on an individual basis, taking into account all the characteristics of the woman's body. As an additional tool for the treatment of fallopian tubes, physiotherapy is used. In combination, these two tools give excellent results.

Also widely at the initial stages of the disease, microclysters can be used. Very often, the patient is prescribed autohemotherapy. The essence of this procedure is that blood is taken from a vein and injected intramuscularly. In this way, the defense mechanisms of the body itself are spurred on, and it begins to fight the infection intensely.

To maintain the patient's condition at a certain level, the patient is prescribed a course of vitamins, which can be taken either orally or by injection. A positive result is the use of physiotherapy procedures.

In various sources, you can find information that the use of leeches has a positive effect on the patient's condition. In fact, no studies have been conducted on this issue and there is no evidence of the effectiveness of such treatment.

Traditional healers also give recommendations on the treatment of this disease with their own methods. It should be noted right away that these funds should not completely replace the medical treatment prescribed by a specialist doctor.

Otherwise, the disease will be launched and there is a risk that it will become chronic. Alternative methods of treatment should be used as an additional remedy.

Medicinal preparations offered by folk medicine for the treatment of hydrosalpinx act selectively on some properties of the body, affect the menstrual cycle, can slightly slow down the formation of adhesions, and relieve pain. Here are some simple recipes:

• Collection 1. Consists of St. John's wort, sage, currant leaf, chamomile. It is used as an infusion.
• Collection 2. Includes an infusion of adonis. In order to prepare the remedy, take 1 tbsp. l. pre-chopped herbs and pour a glass of boiling water. They let it brew. After 30 minutes, the product can be used. Take it for 1 tsp. 3 times a day at regular intervals. This remedy must be used with great care after a mandatory consultation with a doctor, since the adonis (second name - adonis) in case of an overdose gives a lot of unpleasant side effects.
• Collection 3. Infusion of branches and berries of juniper. Used for taking baths.
• Collection 4. Consists of oak bark, calendula, pharmacy chamomile. Used for microclysters.

With hydrosalpinx, you can not self-medicate. Mild pain syndrome, slight vaginal discharge may suggest that the disease is not serious and that it is possible to cure it on your own.

In fact, the consequences of improper treatment can be very serious. Therefore, if you suspect this disease, you should immediately consult a doctor.