As you know, the uterus and ovaries are connected by the fallopian tubes, which play an important role in our reproductive system. After all, meeting of ovum and sperm takes place over there, and then the transportation of the embryo to the uterus. The normal functions of the fallopian tubes can be impaired, for example, due to inflammation (salpingitis), or as a result of hydrosalping - the accumulation of serous fluid in the lumen of the tube.
The causes of pathology include:
- transferred infections in one or two fallopian tubes;
- endometriosis;
- surgical interventions on the tubes or uterus that lead to adhesions;
- sexually transmitted infections;
- complicated childbirth and abortion.
Symptoms
In some cases, hydrosalpinx is completely asymptomatic, without any painful episode that would make you think about a visit to the doctor. In such cases, the problem can only be detected with a routine ultrasound examination.
. If hydrosalpinx does not manifest itself symptomatically, the impossibility of getting pregnant for more than 12 months of unprotected sex becomes an “alarming call".
In other cases, the pathology causes pain in the pelvic area, which increases with menstruation. Pain can be especially expressed during intercourse or at the end of it. In addition, there is an increase in temperature, a violation of the menstrual cycle.
To diagnose hydrosalpinx, hysterosalpingography is recommended. This examination consists of an X-ray with a contrast agent, and, in addition to assessing the morphology of the uterus, allows you to check the patency of the fallopian tubes.
Serous effusion present in the tubes is detected by transvaginal ultrasound. (Healthy fallopian tubes are not visible on ultrasound.)
Also, for the diagnosis of pathology, laparoscopy may be advisable. Basically, this procedure allows you to examine the surface of the pipes and find out if they are blocked or not. If there are no obstacles, then a special fluid introduced through the uterus will pass through the tubes without problems.
If hydrosalpinx is left untreated, the risk of infertility and ectopic pregnancy increases. Also, the disease can flow into an inflammatory-purulent form. A serious complication is pipe rupture. Pus may erupt into the vagina, bladder, or accumulate as an isolated abscess in the Douglas space.
Treatment
hydrosalpinx therapy is primarily aimed at solving the problem of the couple's infertility. Lately, a lot has changed in the field of reproductive medicine. Previously, interventions were actively used to reconstruct pipes and restore patency. However, statistics show that the effectiveness of such operations in terms of achieving pregnancy is low. Often the surgery itself leads to adhesions and increases the risk of an ectopic pregnancy.
However, it should be understood that this approach has its own nuances. IVF with hydrosalpinx may fail as tubal exudate enters the uterus. The fluid contains toxins that prevent the embryo from penetrating into the lining of the uterus and create unfavorable conditions for pregnancy. This may explain infertility in patients with unilateral hydrosalpinx.
It seems that nothing should interfere with the passage of the oocyte from the healthy side. But pregnancy does not occur or does not develop: the exudate from the diseased tube does not allow the embryo to gain a foothold. Based on this, before IVF, the removal of the tube affected by hydrosalpinx is practiced.
