Is it possible to get pregnant with hydrosalpinx? Important facts about pregnancy and hydrosalpinx

It is a bag of overgrown connective tissue (pseudocyst), which is filled with transudate - a fluid secreted by the mucous, extracellular and blood plasma against the background of the inflammatory process. Pathology is detected during a planned ultrasound, as it is often asymptomatic.

The beginning of the development of the disease is acute inflammation of the fallopian tubes (acute salpingitis), under its influence exudate (inflammatory effusion) is formed, in which the walls of the tubes are soldered and form an isolated cavity.

Neoplasms prevent the movement of the egg into the uterus, which leads to tubal infertility. With unilateral expansion, it is possible to get pregnant through the remaining healthy tube, but with bilateral expansion, complete infertility occurs. Such a disease reduces the chances of a woman by 4 or even 5 times to give birth to a baby through IVF, leads to miscarriages, ectopic pregnancy. With tubal infertility, 30% of women were diagnosed with this diagnosis.

The contents of the hydrosalpinx, entering the uterine cavity, can mechanically wash out the transplanted embryo. The composition of this fluid carries the threat of infection, spreading microorganisms with toxins and infection. Pathological changes in the endometrium in the presence of hydrosalpinx were revealed.

When diagnosing Hydrosalpinx, the ICD code is prescribed in the medical history - 10 - N70.1 Hydrosalpinx - Acute salpingitis and oophoritis (salpingoophoritis).

Classification

Hydrosalpinx is a complicated form of acute salpingitis (a separate focus of inflammation of the fallopian tubes). It is diagnosed less frequently than the general inflammation of the tubes and ovaries - salpingo-oophoritis.

From the affected area happens:

1. One-sided - the adhesive process takes place in one of the pipes. The patient has one healthy oviduct, which makes it possible to conceive naturally.
2. Bilateral - pathologies were detected in two fallopian tubes, which leads to their blockage and complete infertility.

Filling the marsupial space with pus is called pyosalpinx. With this type of pathology, fusion of the fallopian tubes is observed due to the thick consistency of pus, the mucous membrane of the tubes is destroyed.

According to the number of cavities is divided into:

1. Simple - the formation of one isolated cavity.
2. Follicular - the appearance of several cavities with dividing partitions.

When emptying the fluid into the uterine cavity, a draining hydrosalpinx is diagnosed.

According to the degree of the disease, it can be acute or chronic.

Features of the course of the disease

Even if you know what hydrosalpinx appears from, it is sometimes difficult to detect it. After all, the disease passes with virtually no symptoms. Only if an acute stage of the disease is formed, then the body temperature can rise to 39 degrees Celsius, and it is not always possible to understand what exactly caused it to rise. At this time, the patient experiences severe fatigue, rapid onset of weakness. One of the clear signs of the disease is arching pain in the pelvic area. Periodically there is a tachycardia. With inflammation, the problem area can protrude and be palpated. It increases by several centimeters and touching it will be painful.

This is a completely curable disease and the sooner it is detected, the easier it is to get rid of it. Most often, it is discovered if the couple cannot become pregnant for a long time and undergoes an examination.

Causes

The beginning of the development of the disease is a violation of the outflow of fluid from the fallopian tubes with an acute inflammatory process. Inflammation is caused by more than one microorganism, and it can get there not only sexually, but also through the blood from an infection in other organs.

Inflammation is caused by:

• endometritis;
• sexually transmitted diseases;
• changes in the permanent microflora of the vagina associated with frequent changes of sexual partners;
• hypothermia, decreased immunity;
• surgical intervention in the genitals;
• contraceptives inside the uterus;
• injury and infection of the cervix;
• long-term inflammation in the vagina;
• non-compliance with the rules of intimate hygiene;
• hormonal diseases and endocrine system;
• diabetes mellitus and thyroid disorders.

The huge circulatory system of the fallopian tubes contributes to the rapid spread of inflammation and the transfer of infection to other tissues. With hydrosalpinx, inflammation often occurs in the uterus and ovaries. To block the source of infection, the ampullar section of the tube (the connection with the abdominal cavity next to the ovary) closes, which provokes the formation of a hydrosalpinx. But with a good immune system and prompt intervention, such a diagnosis can be avoided.

Methods of infection of the oviduct:

1. Ascending - the infection often ascends through the reproductive canals from the vagina, cervical canal, and uterus.
2. Descending - rarely occurs, is carried through the blood from other infected organs (kidneys, intestines, urinary system).

Hydrosalpinx: causes in women

The main causes of tubal obstruction include:

• Inflammatory diseases that manifest themselves in the pelvic region (this can include gonococcal or chlamydial infection);
• ovulation induction;
• endometriosis;
• The appearance of adhesions in the fallopian tubes from diseases of the pelvic organs;
• Hysterectomy can lead to unilateral and bilateral obstruction;
• Primary or secondary malignant tumors that occur in the fallopian tubes;
• Fallopian tube ligation procedure;
• Accumulations of uterine secretions that occur during surgical interventions.

It should be understood that the causes of hydroslpinx on the right and on the left can be the same. If we are not talking about surgical intervention, then it is never known exactly which tube can be affected by the disease and which will have the most serious consequences. In the worst case, both pipes will be affected.

What does hydrosalpinx look like: symptoms and treatment, reviews

Hydrosalpinx refers to those diseases in which symptoms practically do not manifest themselves until a really difficult and dangerous situation arises. Almost all the first stages are asymptomatic, with rare exceptions. A woman often does not even understand that something is going wrong, and, accordingly, she tries to pass the examination. If there is pain during hydrosalpinx, then this also cannot always be perceived as a signal for action. Only prolonged pain can make a woman see a doctor.

The accumulation of fluid in this disease may not cause discomfort until it gains a large mass and begins to protrude. If we consider what hydrosalpinx looks like, symptoms and treatment, reviews of this disease, then we can understand the seriousness of the absence of symptoms in the first stage. Hydrosalpinx is manifested in the form of inflammation in the fallopian tubes, which is caused by the accumulation of white fluid. This is not natural and leads to obstruction of the tubes.

signs

Due to inflammation of the fallopian tubes, their walls thicken, the gland begins to actively produce an inflammatory fluid (exudate). With an excess of contents, the walls of the tube stretch and become thinner, patients feel heaviness, pressure in the lower abdomen. The acute form gives cutting and throbbing pains in the pelvis, groin, the temperature rises, which is often confused with appendicitis, colic in the intestines and kidneys. In the chronic form, the symptoms are smoothed out.

When the fluid is poured out, discharge from the vagina appears. Malaise, chills, fever, poor sleep are signs of pyosalpinx. Under the pressure of the fallopian tubes, the ciliated epithelium is damaged and dies under the influence of inflammation. Dead tissue turns into adhesions, the movement of the egg through the tubes becomes impossible, infertility occurs, and damage to the peristalsis of the tube leads to an ectopic pregnancy.

Complications of such a diagnosis will be a rupture of the tube, which causes acute pain in the abdomen, rupture of the purulent sac and infection of the abdominal cavity, bladder, rectum, which will lead to peritonitis.

The most pronounced clinical signs of the disease appear during adhesive processes in the pelvic organs.

Signs of hydrosalpinx on the right

If the hydrosalpinx is on the left, the signs will be almost the same. This disease is characterized by the fact that it can appear in any fallopian tube of the female body. There is no fundamental difference between its flow in the right and left parts. It also does not matter if the hydrosalpinx goes in both tubes.

Symptoms of hydrosalpinx on the right

As well as in the study of signs, if the hydrosalpinx is on the left, the symptoms will be the same as on the right. One of their features is that the symptoms of almost all diseases are almost the same. This complicates the ability to determine what exactly is worth diagnosing, but makes it clear that we are talking about inflammation.

Considering hydrosalpinx symptoms on the forum and in other places, the main ones can be distinguished:

• Pain in the groin. This can manifest itself as pain directly in the appendages or pain in the entire groin, as each woman can experience this individually. If the pain is localized only on the right or left side, then you can easily understand which pipe there are problems with, but just in case, it is worth examining the second one. The pain can be aching, throbbing and prickly.
• High body temperature. As a rule, during the transition of the disease to a serious stage, inflammation makes itself felt throughout the body. This manifests itself in the form of a significant increase in temperature, up to 39 degrees Celsius. Together with other symptoms, this helps to diagnose hydrosalpinx at a high stage.
• Malaise and the rapid onset of fatigue are common if the disease has not yet fully manifested itself. Often, after such fatigue, pain worsens, which indicates the need for examination. Delaying this process only worsens the situation.
• Painful touches to the area of ​​​​the appendages also make it clear what is just wrong with them.

Reading reviews from women about the symptoms of hydrosalpinx, you can often find such information that all the first symptoms were attributed to painful sensations before menstruation. In the female body, changes often occur that can be painful, manifest in malaise, and so on. To avoid mistakes, you need to carefully monitor the course of the cycle in order to know exactly on which dates all this can really be attributed to menstruation. For example, with hydrosalpinx, temperature can be easily perceived as a symptom of another disease, especially if its other manifestations are absent.

Hydrosalpinx rupture: symptoms

If the accumulated fluid causes the fallopian tube to burst, then this indicates a very serious complication. As a rule, before this, all the above symptoms are clearly manifested. The fact that a rupture has occurred can be indicated by a strong sharp pain, during which the pipe breaks. This increases blood pressure and all this is accompanied by tachycardia. But this situation only speaks of the beginning of a gap, since other symptoms should appear in the future.

After fluid enters the body from the tubes, pale skin and cold sweating may occur. The body goes into a state of shock. In addition to being unnatural for a normal condition, hydrosalpinx fluid can lead to other ailments such as:

• Douglas pouch abscess;
• Pelvioperitonitis;
• Peritonitis.

In the worst case, the breakthrough of pus can occur in the rectum, bladder or vagina. This suggests that these parts of the body can also become inflamed.

When a hydrosalpinx ruptures, the patient urgently needs professional medical care. It is necessary to clean the internal cavities from the erupted fluid, as well as solve the problem with the fallopian tubes. Often, a torn appendage is simply removed so that the infection does not spread further.

Due to timely diagnosis, situations with a gap do not happen so often. This is the last stage of the disease, in which the inflamed part of the body simply cannot withstand the fluid accumulated in it. The reason for a breakthrough can be a sudden movement, overexertion, excessive pressure on the diseased area, and so on. It is best to resolve all this before the occurrence of such complications, but it does not hurt to know what actions to take if symptoms of hydrosalpinx rupture occur.

Hydrosalpinx: types

Hydrosalpinx can manifest itself in various forms, depending on which organ is affected and how severe it is. All this is purely individual, since it is not known when the disease appears and how quickly it can develop into a more serious stage. Bilateral hydrosalpinx is one of the more difficult options, as it can cause loss of both tubes and become infertile, but it is not the only type of disease.

Left-sided hydrosalpinx of the ovary

This type refers to unilateral hydrosalpinx. The cause of the occurrence is adhesions on the left fallopian tube. As a result, liquid accumulates only in it. The right pipe can function quite normally. This is a common occurrence when only the left side is affected. On visual inspection, you can see that a light liquid is visible through the walls, and the inflamed area itself is enlarged in size. Cyst formation most often occurs on both sides.

Right hydrosalpinx

In this case, almost everything coincides with the left-sided formation. Symptoms and other manifestations correspond to the previous case. At the same time, a prerequisite for such a diagnosis is that the second fallopian tube remains healthy. Thus, with a unilateral disease, infertility does not occur, but the chances of getting pregnant are halved. During the first cycle, the egg must come from one tube, and during the second cycle, from the other. Due to this, conception remains possible only in the cycle when a healthy fallopian tube is working.

Bilateral hydrosalpinx

This is still the same disease, but in a more complex form, since fluid accumulates in both pipes. Pain from sprains and from inflammation begins on both sides, so it is also easy to identify this variety. Due to inexperience, women can confuse the symptoms with other diseases or attribute them to periodic pain before menstruation. The sensations do not always become sharp, as they often have a long aching character. Taking into account the fact that the ovarian cyst and hydrosalpinx are formed on both sides, on two tubes at once, it diagnoses infertility. The eggs do not have a chance to enter the uterus for fertilization. A complete blockage of the fallopian tubes, with a possible risk of rupture, can lead to a situation that requires the removal of the tubes, after which natural conception will not be possible even after the hydrosalpinx has been cured.

Due to the fact that the uterine fluid blocks the tube, the sperm also cannot get inside. In this case, there is no risk of ectopic pregnancy, but the chances of fertilization disappear almost completely.

Chronic hydrosalpinx on the left photo

The chronic form is a particular danger. The fact is that it begins most imperceptibly. A sluggish process that continues for a very long time leads to the fact that the cilia of the fallopian tube stick together without pain and other obvious signs. There is no discomfort and the woman does not go to the doctor. But all this time, the exudate continues to accumulate, which can eventually lead to rupture of the fallopian tubes. The chronic form is difficult to detect, so in most cases it is diagnosed incidentally during a pelvic exam. In this case, it is quite normal if the patient has not felt any pain before. Only when a significant increase in the pipes begins due to the accumulated fluid, heaviness in the abdomen begins. In the later stages, a feeling of a foreign body inside the body is created. But the temperature remains the same. Chronic left hydrosalpinx (sactosalpinx) is no different from the right or bilateral, except for the location.

Valve hydrosalpinx of the left tube

The valve type of the disease is characterized by the loose formation of adhesions. In the usual embodiment, the formation creates such conditions under which the liquid cannot pass, since a solid blockage is formed. If valve hydrosalpinx is observed, then everything is not tightly clogged here, and with the accumulation of a certain amount of uterine fluid, a breakthrough begins. It is not the pipe itself that breaks, as it could be in previous types of the disease, but the blockage itself. Over time, a new one forms and the process repeats. At this time, obstruction of the fallopian tubes is observed. One of the signs of this type of disease is periodic watery discharge. Sometimes there is slight pain during the rupture.

Follicular hydrosalpinx of the right ovary

In a simple form of the disease, one cavity is formed in which fluid accumulates. As a rule, it has two closed entrances, but it is possible that only one side can be closed. If a follicular hydrosalpinx is formed, then several cavities may appear in one fallopian tube. They are located nearby and fluid accumulates in all of them. This form is more dangerous and difficult to treat. Follicles can appear in any number, but two on one tube are enough to diagnose this form. There may also be bilateral hydrosalpinx and left-sided. All this makes the tubes impassable and often doctors decide to remove them if there is an acute stage of the disease.

Right ovarian cyst hydrosalpinx on the right, what is it, patient reviews

A cyst often occurs due to the eggs that have not completed a full cycle, which have stopped yet in the fallopian tubes, without reaching the uterus. This is a fairly common phenomenon among women, but it does not always give complications. It all depends on how unsuccessfully the cyst formed. Periodically, adhesions form because of it, since the fallopian tubes are quite thin and any neoplasm blocks the passage into them. According to patients, operations are mostly successful, especially with early detection of the disease.

Diagnosis of hydrosalpinx

There are always problems with the diagnosis of hydrosalpinx, since the symptoms of the disease often do not manifest themselves. Even in complex forms, women do not always pay attention to pain. But if you specifically look for and conduct the necessary research, then it is quite possible to detect fluid accumulations. Diagnosis of hydrosalpinx is carried out using special instruments and devices, since it is almost impossible to visually determine the state of internal organs.

Often, this disease is diagnosed when a woman comes to see a doctor about the absence of pregnancy. In addition to the examination on the chair, the gynecologist takes smears to detect all kinds of diseases and inflammatory processes, an ultrasound examination is prescribed. This instrumental examination method allows you to see the deformation of the fallopian tubes with the formation of cavities filled with homogeneous contents in hydrosalpinx and heterogeneous in pyosalpinx. Such a neoplasm differs from a cyst in its own capsule, partitions. But if the pathology is poorly expressed, then such a study may not detect changes in the organs.

With further research, the doctor prescribes a detailed study of the patency of the pipes by salpingography. This method shows whether there is a blockage and whether pregnancy is possible. A contrast fluid is injected into the fallopian tubes and an X-ray study is performed, which shows that if the tinted fluid has entered the pelvic cavity, then it has successfully passed through the tubes. Otherwise, the contrast fluid fills the entire cavity of the fallopian tubes, showing all the flaws, and accumulates in the amplural department.

Today, laparoscopy remains the most relevant and effective diagnostic method.

Laparoscopy is a modern method of surgical intervention and determination of an accurate diagnosis. Penetration into the body occurs through small holes of 0.5-1.5 cm, sparing damage allows the patient to quickly return to normal life. This method is successful in removing adhesions, treating infertility and endometriosis.

Is hydrosalpinx visible on ultrasound?

Ultrasound is one of the simplest and most affordable methods for determining this disease. Ultrasound shows the hydrosalpinx quite well. For the procedure, it is necessary to use a special ultrasonic sensor, which is inserted into the vagina. The device sends out waves that reveal the internal structure of the pelvic organs. In the normal state, as a rule, the fallopian tubes are not visible in such a study. But if liquid accumulates in them, it will become noticeable. On ultrasound, signs of hydrosalpinx are clearly visible, as enlarged tubes with fluid clearly show through. It is especially noticeable in the unilateral type of the disease, when one fallopian tube is visible, but the other is not. This method is most often used at the first examination. On ultrasound, signs of a right-sided hydrosalpinx will appear as a brighter manifestation of the tube on the right side.

Ultrasound can be:

1. Transvaginal is an informative diagnostic method using a vaginal probe that is inserted into the vagina. The sensor is a handle 12 cm long and 3 cm in diameter. There is a needle at the end of it, which, if necessary, allows a biopsy. Such a proximity of the sensor to the organs makes it possible to obtain detailed results.
2. Combined - a combination of transabdominal (through the anterior abdominal wall) and transvaginal, which reduces the chances of missing unexpressed changes in the genital organs.

Hysterosalpingogram

This method uses x-rays to detect disease. For its implementation, it is necessary to introduce a dye into the uterine cavity, it must penetrate the fallopian tubes in order to see during the examination whether there is patency in them or not. The dye easily seeps through the uterus into the fallopian tubes. After its distribution, you can see almost all changes in the internal structure, since the dye contrasts well with the image and shows a picture of the patency of the female reproductive system.

The addition of dye is mandatory, as this is the only way to identify hydrosalpinx on photo x-rays. In the event that everything is in order with the pipes and they are open, then the coloring liquid easily passes through them to the required areas. If a woman has a hydrosalpinx, then the dye will not be able to freely pass through the fallopian tubes, as they are blocked by another fluid. On the image, the pipes will appear stretched.

Hysterosalpingogram should be performed in the second week after the start of the menstrual cycle. It must be done at a time when the bleeding has already stopped, and ovulation has not yet begun. On average, the diagnosis takes about 10 minutes, depending on the circumstances. Here, the occurrence of side effects in the form of cramps and pain in the pelvic region is likely. Pain medications can be taken both before and after the procedure, but it is advisable to do this under the direction of a doctor. Any recovery period after the procedure is not provided, since the woman's performance does not suffer from this.

Laparoscopy

This diagnostic method refers to surgical intervention. With the help of a laparoscope, thanks to which the technique got its name, the surgeon penetrates inside, under the skin of the patient. At the thin end of the instrument is a camera that shows what the fallopian tubes look like. To enter the laparoscope inside, a small incision is made in the navel, after which the technique freely penetrates into the pelvic region. This allows you to visualize on the screen the state of the examined internal organs. Due to the high complexity of such a diagnosis, it is not used as often as others. Laparoscopy is performed in cases where there is a suspicion of hydrosalpinx and it is necessary to confirm exactly that an operation is required. During the procedure, general anesthesia is used, as it provokes unpleasant and painful sensations.

MRI hydrosalpinx on ultrasound

The use of MRI is also used for diagnosis. This is less common than a conventional ultrasound because the procedure itself is more expensive. At the same time, MRI helps to more accurately determine the condition of the tubes and view them from all sides. Also, not all clinics have MRI for diagnostics. In general, the procedure is painless and does not take much time. It has no contraindications for hydrosalpinx and can be used in almost any case. It can be used to clarify the diagnosis.

Is it possible to see hydrosalpinx on ultrasound: ultrasound photo

Ultrasound examination for diagnosis is used most often, as it is the simplest and most affordable method. But this is not always an effective solution, as there is a risk that something will not be visible on the ultrasound photo. In most cases, the echo signs of hydrosalpinx are determined normally. If the disease is at the very initial stage, then it cannot always be determined. This is due to the fact that the tubes themselves are not visible on ultrasound. A small amount of fluid may also not appear.

It all depends on the device and the specialist who conducts the study. An experienced doctor will be able to determine the formation or prescribe additional procedures. It is in the initial stages that there are no symptoms of the disease. Other methods may also fail to diagnose. But in most cases, the disease can be detected already at the stage when the fluid has accumulated in the proper amount, so that it can be seen on ultrasound, x-rays and other devices.

In general, modern diagnostic methods are able to recognize hydrosalpinx at that stage so that it can be cured in a timely manner. Here, the safety of the patient plays a big role and the fact that such inflammation does not happen so often that annual preventive examinations are carried out. When planning a child during the examination, each doctor knows how to detect hydrosalpinx on an ultrasound indication.

Is there a cure for hydrosalpinx?

Like any other disease, hydrosalpinx can be cured. The method by which this will happen is chosen by the doctor, depending on the type of disease and the health of the patient. Hydrosalpinx is treated with several proven methods. The effectiveness of their use depends on the neglect of the disease and its form.

Treatment

Drug treatment of this disease is impossible, but even with surgical intervention, no one can give guarantees for natural conception. When removing neoplasms and restoring the lumen of the tubes, it is not always possible to restore the peristaltic function of the fallopian tubes. Inflammation leads to deformation of the mucous walls, death of the ciliated epithelium, which blocks the passage of eggs into the uterus. The only way to get pregnant is in vitro fertilization, and to improve its results, removal of an obstructed tube is recommended.

The initial stages of treatment include antibacterial, anti-inflammatory therapy, vitamin therapy, physiotherapy (electrophoresis, magnetophoresis, laser phoresis).

Drugs used in drug therapy:

1. Antibiotics - prescribe a wide area of ​​action, such as Cefalexin, Ecocephron, use Erythromycin, Metronidazole, Tetracycline. They remove inflammation in the bladder.
2. Antifungal - antibacterial drugs are taken together with Nystatin, Miconazole, Lamisil, Diflucan.
3. Probiotics - reduce the negative effect of antibiotics on the intestines. Prescribe Linex with Vitaflor.
4. Anti-inflammatory - have analgesic, anti-inflammatory properties and reduce fever. They use Paracetamol, Nurofen, and also help with Diclofenac and Voltaren.
5. Fibrinolytic - promote the resorption of small adhesions in the body. Longidaza, Trypsin, Lidaza are prescribed.
6. Immunomodulating - strengthens the immune system. Immunal, Taktivin, Imudon are involved.
7. Vitamin - take either separately vitamins B, A, C, E, or in a complex Vitrum, Triovit.

Self-medication in this case with antibacterial drugs or folk remedies can drown out the symptoms of the disease, and it will go into a chronic stage, where inflammatory processes will progress and lead to rupture of the fallopian tube.

At the initial stage, you should determine:

• focus of infection and medicines to eliminate it;
• type of pathologies in the affected areas;
• the area of ​​the lesion, and which organs are affected;
• dishormonal disorders.

The second stage of treatment is the surgical removal of the hydrosalpinx, the expansion of the lumen in the tubes, the elimination of adhesions, if it is impossible to restore the fallopian tube, it is eliminated. This is exactly what laparoscopy does. In the postoperative period, the doctor recommends mud therapy, hydrotherapy, electrical stimulation of the fallopian tubes.

With prolonged inflammation, which is typical for a chronic form of the disease, adhesive phenomena in the abdominal cavity, even after removal of the hydrosalpinx and expansion of the fallopian tubes, women cannot have children.

Is it possible to cure hydrosalpinx: treatment methods

The conservative method of treatment is divided into several stages. All of them should be under the supervision of a doctor, since self-medication will only worsen the situation, especially since the transition to a neglected form threatens to lose the fallopian tubes. The following steps can be distinguished:

1. The first step is to remove the inflammation, which is localized in the fallopian tubes. It is this that leads to the appearance of painful sensations with hydrosalpinx.
2. At the second stage, antibacterial and physiotherapy are prescribed to remove the risk of spreading the infection and infection with something during this dangerous period.

This method does not always help, and it is mainly used when a disease is detected in the early stages. Considering the question of whether hydrosalpinx is treated with conservative methods without surgery, many doctors can give a negative answer. In fact, a positive effect is really rare, but still possible.

Most often, when a hydrosalpinx is found on the right, the treatment is prescribed surgically, since the detection of the disease occurs already in the later stages. Considering all possible options, how to treat hydrosalpinx on the left, on the right or bilaterally, specialists often tend to choose such an option as laparoscopy. Today it is one of the most preferred choices. During the operation, doctors try to plasticize the fallopian tube, which has been damaged by the disease. The adhesions are separated, after which the patency is restored. Specialists treat the surface from the outside and inside, which leads to a complete recovery. If it is not possible to achieve the desired effect and the patency is not restored, then doctors recommend removing the damaged fallopian tube so that there are no further complications. Also, the need for a pipe disappears if it cannot restore its functionality.

When hydrosalpinx is diagnosed on the left, treatment may include a salpingostomy. For this, endoscopic equipment is used, which helps to get rid of the obstruction of the fallopian tube, namely, the ampoule. During the operation, an opening is created at the entrance from the uterus to the tube.

Fimbriolysis can also be used to separate fimbriae that have grown together from a hydrosalpinx. If the fallopian tubes are too narrow for the passage of the egg, then this procedure will help solve this problem. The operation is prescribed when the stage of the disease is still at a relatively low level, but without surgical intervention, it is impossible to solve everything. If the doctor, when deciding which hydrosalpinx treatment to choose in this case, tends to fimbriolysis, then everything takes place under general anesthesia. All actions must be clear and subtle, so that any unnecessary movement of the patient can complicate the procedure.

Salpingneostomy also serves to create an artificial opening in the fallopian tubes. During the operation, the resulting clogged areas are cleaned, so that the liquid does not accumulate, as before. This operation is prescribed if the creation of an artificial hole becomes the most preferable solution and other methods cannot be helped. This method helps with almost all types of tubal infertility, if it is possible to maintain the functionality of the tube.

Hydrosalpinx of the fallopian tubes: treatment with folk remedies

These funds are good not only as the main means of getting rid of the disease, but also as prevention and support during the recovery period after surgery. Before using any of the methods, you should consult your doctor. Clay baths are one such remedy. They are sometimes prescribed by doctors in the postoperative period, if it is possible to carry out this procedure. It is worth knowing that it is not recommended to stay in the bathroom for more than half an hour, as this can backfire.

When considering the treatment of hydrosalpinx on the forum, you can find reviews that douching from a flower decoction helped. It includes the following components:

• Coltsfoot;
• Oak bark;
• Chamomile;
• Mallows.

Douching is carried out only with hot decoctions, as this significantly increases the effectiveness of treatment. The duration of the course is 1 month. Ingestion of a decoction is also possible. Among the useful substances in this disease will be fresh pumpkin juice and nettle decoction.

Activation of the immune system

In some cases, experts enable the body to overcome hydrosalpinx on its own by activating the body's immunity. For this, special immunocorrective preparations are used. These funds include:

• Aloe injection;
• Imudon;
• Immunofan.

Additionally, autohemotherapy technology can be used. It consists in the fact that the patient is injected with her own blood under the skin or into the muscles. It helps tissue repair. Thus, one can hope for a natural restoration of the fallopian tubes by the body's own forces. This is true only in the initial stages of the disease.

How to anesthetize hydrosalpinx: physiotherapy

A number of physiotherapeutic procedures that are used during the treatment of this disease include the following:

• ultraviolet irradiation;
• UHF rays;
• Magnesium electrophoresis;
• potassium electrophoresis.

It is not worth waiting for a highly effective healing result, but tissue restoration and pain reduction are quite possible here.

Prevention

The female body is very complex, and many diseases are asymptomatic or with minor signs. Doctors recommend to be examined by a gynecologist every six months, to take routine tests to prevent serious diseases. Immediately treat all identified infectious and inflammatory processes, strictly follow the doctor's prescription. Lead a healthy sex life, avoid abortions and maintain basic hygiene.

Hydrosalpinx: consequences

Among many diseases of the pelvic organs, hydrosalpinx is distinguished by serious consequences that can turn into big problems for women's health. Complications of hydrosalpinx can be divided into those that occur during the course of the disease and those that appear already in the later stages.

What is dangerous hydrosalpinx of the fallopian tube in the early stages

The initial stages of the disease for a woman's well-being and performance do not pose any danger. For a long time, the patient may not notice that something is wrong with her. In fact, the fallopian tubes, which are the main site of hydrosalpinx damage, are involved only in the reproductive process and their dysfunction does not manifest itself in any way on human activity.

Even if hydrosalpinx is diagnosed in the early stages, the consequences can be serious for those who want to give birth. Even at the very beginning of the accumulation of fluid, the output of which is blocked by adhesions or cysts, the egg cannot move forward. If one tube is affected by the disease, then the chance of getting pregnant is halved. Thus, pregnancy can only occur through a cycle. If bilateral hydrosalpinx is diagnosed, then here we can already talk about tubal infertility. Until the patency of these organs is restored, it will be impossible to get pregnant in a normal way, even with normal ovarian function.

In addition to infertility in the initial stages, hydrosalpinx gives inflammation. This is a long process, which manifests itself differently for every woman. Inflammation occurs from fluid stagnation. This can lead to inflammation of not only the tubes, but also the ovaries, uterus and other adjacent organs. During inflammation, cutting, throbbing or dull pains are felt. Also, the organs stop working normally until the inflammation is removed.

One of the consequences of the initial stage may be an ectopic pregnancy. This can happen when conception was nevertheless made, but due to inflammation, the walls of the tube could not remove the fertilized egg from the fallopian tube.

The pipe burst with hydrosalpinx: consequences

The second set of negative factors are those that arise already in the later stages. The most serious consequence is the removal of the fallopian tubes, the adhesions on which could not be removed, as well as the removal of the organs themselves. Thus, once again, the disease can lead to infertility. In the last stages, sharp pains, malaise and even fever from inflammation are felt. If the operation is not carried out, the consequences can become very serious.

Many people wonder if a pipe can burst with a hydrosalpinx from a large amount of accumulated fluid. Naturally, this is quite possible and such a phenomenon becomes one of the most difficult consequences of the disease if it is not treated. This can happen at any time and the restoration of this part of the body becomes almost impossible. Surgeons can do a tubal plasty, but restoration does not help restore the former functionality. In other words, the walls of the tubes do not push the egg, which can lead to an ectopic pregnancy. It is for this reason that experts consider the plasticity of these organs to be meaningless.

There are a number of other questions that patients have. For example, if a hydrosalpinx burst, is this a sign of HIV? Experts assure that this phenomenon has nothing to do with HIV.

A serious consequence of a burst pipe is infection of the internal organs of the small pelvis, since stagnant fluid can carry many negative effects when in contact with healthy tissues. After a rupture, an operation must be performed to eliminate the consequences. If the breakthrough is large, then the fallopian tube is removed. If it is possible to restore it, then every possible attempt is made to do so. In any case, it is necessary to clean the organs from the liquid that has fallen on them and carry out restorative therapy. Taking into account the prevalence of the situation, many negative consequences turn out to be completely solvable, since IVF can be performed even with infertility.

Pregnancy after hydrosalpinx, is it possible

Most often, a disease such as hydrosalpinx is detected during the planning of a child, when a woman is examined and obstruction of the fallopian tubes is detected. Accordingly, such questions immediately arise as whether it is possible to become pregnant with hydrosalpinx of one tube, two tubes, and at what stage of the disease infertility occurs.

Does pregnancy occur after hydrosalpinx?

Many are of the opinion that the only way for a woman to become pregnant after hydrosalpinx is IVF. In fact, this is not entirely true, although in the vast majority of cases it happens. IVF becomes the last option only when there is inflammation and adhesions in the fallopian tube, blocking normal patency. Not with all forms and stages of hydrosalpinx, this manifests itself so strongly. As a rule, only during the illness itself it is impossible to get pregnant. And if she did not go into a difficult stage, after which the pipes themselves became affected, then it is quite possible to become pregnant naturally.

In all other cases, when the egg cannot independently pass from the ovary to the uterus, pregnancy cannot occur. Then IVF becomes the only chance to get pregnant with the help of your genetic material. It should be understood that hydrosalpinx does not affect the functioning of the ovaries, if it does not go into a difficult stage and the eggs are also produced after the removal of the fallopian tubes. So the stories of those who got pregnant with hydrosalpinx are very real.

Who got pregnant with hydrosalpinx: forum

Among the cases in medicine, which are repeatedly described by the patients themselves on the forum, as well as by specialists in their reports, there are many who managed to get pregnant naturally in the presence of hydrosalpinx. It turns out that with hydrosalpinx you can get pregnant if competent medical treatment is carried out at this time. The support of doctors at this time plays a big role, since constant diagnosis with the timely intake of the necessary drugs significantly increases the chances of a successful pregnancy and bearing.

The unilateral type of the disease is the simplest and most often occurs with natural pregnancy. There are cases when the disease is diagnosed after conception during the examination. Thus, the egg from one working fallopian tube was successfully fertilized. In this case, the success of conception, although reduced by 50%, gives many chances for a good completion of the process in a normal cycle. Therefore, the answer to the question, if you have hydrosalpinx on the left, is it possible to get pregnant, it will definitely be “Yes”. After all, the right tube is working normally and can skip the egg into the uterus.

Often there are situations when infertility was caused not only by hydrosalpinx, but also by other reasons, and the disease itself fully ensured the chances of conception. Modern research instruments allow you to accurately determine the thickness of the walls, the presence of adhesions and other problems that a woman may encounter.

Reading about hydrosalpinx and pregnancy on the forum, you can find long stories about all the past analyzes. This helps expectant mothers not to focus so much attention on this particular disease, since infertility can be accompanied by other factors. For modern medicine, the elimination of the hydrosalpinx itself and its negative consequences is not a very big problem. A successful operation and a well-constructed recovery period will make it possible to conceive even without artificial insemination or insemination.

If hydrosalpinx is diagnosed, is pregnancy possible?

Pregnancy is possible even in the presence of hydrosalpinx. Physicians face this problem. That when examining a pregnant woman on an ultrasound analysis, problems with one of the fallopian tubes begin to appear. Do not worry if there is fluid accumulation or inflammation in an already pregnant state. With the competent support of specialists, this disease does not carry any threat of pregnancy. Naturally, the removal operation is not recommended to be done in this condition, and in the acute form, complications may arise. But in the acute form, pregnancy is extremely unlikely, so in the vast majority of cases these are mutually exclusive concepts. As a rule, this is a long-term illness, so there should be no complications throughout the entire pregnancy. Practice shows that children are born as healthy as in women without hydrosalpinx.

What can affect the success of conception after hydrosalpinx

Often women think not only about whether it is possible to get pregnant after hydrosalpinx, but also about how best to do it. Indeed, in some cases, the functioning of the fallopian tubes worsens, therefore, there may be a risk of an ectopic pregnancy. As the main things that can help get pregnant after an illness, it is worth noting:

• IVF is a highly effective universal method of conception that helps with many different problems. It is much more expensive and more complicated than the others, so it is resorted to only in the most difficult cases.
• Insemination - often prescribed by doctors when it is not possible to get pregnant naturally, but all indicators for this are normal. To do this, determine the day of ovulation and produce an infusion of donor sperm directly into the uterus, which increases the chance of conception.
• Using special techniques, postures, hormonal and vitamin support to increase the chance of getting pregnant.

Recovery after surgery, as well as examination to make sure that the condition is normal, are very important factors. After curing hydrosalpinx during pregnancy, special supervision of specialists will be required so that there are no complications. In most cases, everything ends well.

Should I do IVF after hydrosalpinx?

Hydrosalpinx refers to serious pathologies of the fallopian tube, due to which women often cannot become pregnant. Due to the absence of symptoms, the disease is often detected in the late stages, so at the insistence of the doctors, the patient's fallopian tubes are removed. After that, IVF becomes the only way to get pregnant, since even with normal ovarian function, the egg will not be able to get into the uterus for fertilization.

Hydrosalpinx and IVF: reviews

Naturally, the fact of removing the fallopian tubes becomes unpleasant in itself, but the consequences of this are much more important. Judging by the reviews of doctors, the transferred hydrosalpinx reduces the chances of a successful pregnancy, even during IVF. About a third of infertility cases are associated with tubal factor.

If the problem is with only one fallopian tube, then there are practically no problems for IVF and natural pregnancy. It is more difficult to get pregnant with one tube in the usual way, but it is possible. At the same time, IVF is also successful in most cases. The procedure is recommended by specialists if a woman cannot conceive for several years after the treatment of the disease. This applies both to cases where all the fallopian tubes were saved, and those when only one.

The desire to have a child is normal for every woman.

Many families have been planning replenishment for years, but due to health problems they will be disappointed. Doctors pay special attention to the health of the expectant mother.

It is worth considering whether pregnancy and hydrosalpinx are compatible. It is important for a woman to understand what the essence of this disease is, and how necessary its treatment is in order to experience the joy of motherhood.

What is hydrosalpinx

To understand whether pregnancy is possible with hydrosalpinx, it is important to understand what kind of disease it is and how it affects conception. In practice, this pathology is considered a disease that can interfere with a normal pregnancy.

Hydrosalpinx is a disease of the fallopian tubes, in which their patency is significantly impaired. An inflammatory process occurs inside the pipe, fluid begins to accumulate.

As a result, a sac with serous fluid is formed, which is commonly called a hydrosalpinx. In a healthy woman, fertilization occurs in the fallopian tube.

This is where the egg and sperm meet. With obstruction, this either does not happen at all, or an already fertilized egg cannot pass into the uterus.

Another cause of hydrosalpinx is a surgical intervention on the pelvic organs. The risk of developing the disease increases if a woman has had or.

Miscarriage is also a risk factor. While the hydrosalpinx is small, the patient is not bothered by any symptoms.

But as education grows, the following clinical picture may develop:

• periodic increase in body temperature to subfebrile indicators;
• pain in the lower abdomen in the projection of the fallopian tubes - on one or both sides;
• profuse mucous discharge from the vagina, often with a characteristic odor;
• pain during sex.

Such symptoms can be a sign of not only hydrosalpinx, so it is impossible to make a diagnosis only on the basis of well-being. Usually women are diagnosed with this pathology when they seek help for a reason.

Only with the help of a thorough medical examination can pathology be identified and adequate treatment can be selected.

Principles of treatment of the disease

Treatment of hydrosalpinx is carried out only after a thorough medical diagnosis. The gynecologist examines the patient, probes the area of ​​the fallopian tubes.

In the presence of this pathology, on palpation, one can feel a characteristic seal, which, under pressure, causes pain to a woman. An ultrasound examination is carried out.

In a healthy woman, the fallopian tubes are not visible on ultrasound, but after the development of hydrosalpinx, they are filled with pathological fluid and become clearly visible. In severe cases, an additional MRI may be prescribed, which will accurately determine the position of the formation, its size and nature.

Conservative drug therapy is carried out only at the initial stages of hydrosalpinx development. The goal of treatment is to relieve the inflammatory process, due to which the pathological accumulation of fluid occurs.

Antibiotics are used to fight the infection and anti-inflammatories. If conservative therapy does not give a positive effect, a decision is made to conduct a surgical intervention.

Removal of the neoplasm is carried out using laparoscopy. 3 punctures are performed in the abdominal cavity, then the operation is performed.

The advantage of this method is in a short rehabilitation period, the possibility of a full restoration of the fallopian tube and its patency. Full recovery of the patient occurs within a week, and the period of stay in the hospital is only 1-2 days.

Is it possible to conceive after hydrosalpinx?

Pregnancy after hydrosalpinx removal is possible, but it is worth considering the possible risks. Many women have experienced relapses of the disease.

Successful therapy, including full-fledged surgical treatment, is not a guarantee that the adhesive process will not recur.

Relapses with hydrosalpinx occur quite often, which interferes with the full conception of a child. The pathological process begins again and the fallopian tubes again become impassable.

In cases where the formation in the fallopian tubes has been successfully removed and relapse does not occur, the risk of developing an ectopic pregnancy increases significantly.

This is due to the fact that in the process of surgical intervention, albeit the most gentle, the tissues of the ciliated epithelium, which is important for the normal passage of a fertilized egg through the genital tract, are damaged.

Eyelashes are not completely restored, so a woman should be especially attentive to her own condition.

natural pregnancy

Natural uterine pregnancy after hydrosalpinx is possible. Its probability increases after the removal of the affected fallopian tube.

With complete removal, the risk of ectopic pregnancy is reduced significantly, and the possibility of conception increases.

Statistics confirm that a successful operation increases the chances of natural conception: the probability of fertilization and gestation after treatment is 46% or more. This indicator depends on the state of health of the woman, the duration of the course of the disease, the size of the hydrosalpinx.

Conception with IVF

After successful treatment of hydrosalpinx, the probability of conception with the help doubles.

Doctors can freely stimulate the release of a healthy egg and safely implant the embryo into the uterine cavity.

Conclusion

Although this is an unpleasant disease that causes infertility, with the help of qualified treatment, it is possible to cope with the pathology and give birth to a healthy child.

Video: Hydrosalpinx. My history. Removed pipes

Hydrosalpinx is a collection of fluid that has a pale yellow tint, occurring in the right, left, or both fallopian tubes of a woman. This clear fluid is called a transudate. This disease is quite common today. Hydrosalpinx - is it possible to get pregnant and give birth with this disease?

Pregnancy with hydrosalpinx with IVF

It is widely believed that with hydrosalpinx, pregnancy is possible only with the help of IVF, but this is not always the case. IVF is the only way out if the adhesive or inflammatory process occurring in the fallopian tubes is in a severe stage, and the doctor notes the indications for their removal. After this operation, of course, the woman loses her ability to conceive naturally, since the fertilized egg does not have the opportunity to pass into the uterus from the ovary. In this case, you can not do without the IVF procedure, which can replace all the preparatory phases in the process of fertilization and egg transfer. With the help of its implementation, it is possible to localize an already fertilized egg immediately inside the uterus in order to further bear the fetus.

Pregnancy with hydrosalpinx naturally

In medicine, there are many cases when pregnancy with hydrosalpinx occurred naturally during competent treatment. First of all, it should be borne in mind that this concerns the presence of a unilateral hydrosalpinx. If during the study it was revealed that only one fallopian tube is not passable, then the onset of pregnancy is quite possible. But even if adhesions were found in both fallopian tubes, infertility did not necessarily occur against the background of their obstruction.

In medicine, the diagnosis of "infertility" is established when a woman does not become pregnant for several years, subject to an active sexual life. As a rule, in this case, the patient begins to conduct various examinations. With modern diagnostic methods, it is possible to quite clearly establish the presence of fluid and adhesions in the fallopian tubes (performing diagnostic laparoscopy, HSG). But it happens that this is not the only reason why pregnancy does not occur. It is important that a woman does not get hung up on this diagnosis, but is able to collect a complete history, since the fallopian tubes are a small segment of the reproductive system. It is necessary to verify the normal course of the ovulation process when the follicle matures normally, i.e. make sure that the formation of potential eggs occurs without pathologies. In addition, it is important to check the properties of the uterine mucus, whether it is capable of accepting and supporting the growth of the fetus.

The issue of the quality of a man's sperm is considered separately, since pathologies can also be noted in this area. In this regard, in case of infertility, both partners should be examined. When it is established that infertility occurs due to the presence of hydrosalpinx, the doctor prescribes a treatment that maximally preserves the reproductive function of the woman. To date, there are many conservative methods for the treatment of hydrosalpinx, but the most effective is laparoscopy. By removing adhesions that occur in the fallopian tubes using the laparoscopic method, it is possible to achieve a very high percentage of the recovery of a woman's ability to conceive. According to statistics, from 50 to 70% of women have a chance of natural pregnancy after the hydrosalpinx is removed.

Presence of hydrosalpinx during pregnancy

In the event of pregnancy with hydrosalpinx, a woman should not worry that the disease can somehow affect the course of pregnancy. The presence of hydrosalpinx can only interfere with the natural conception of a child. In the presence of hydrosalpinx during pregnancy, the child is born healthy, as in women who do not have this disease.

Prevention of hydrosalpinx

To prevent the occurrence of hydrosalpinx, you must try to protect yourself from various infections, especially those transmitted through sexual contact.

Update: October 2018

One of the unpleasant consequences of inflammation of the appendages, in particular the fallopian tubes, is hydrosalpinx. According to statistics, this pathology occurs in 10 - 30% who are faced with the problem of pregnancy, since hydrosalpinx interferes with successful conception.

But with timely and adequate treatment, the onset of a long-awaited pregnancy is quite possible, so you should not try to get rid of this disease on your own, this only aggravates the pathological process and delays the expectation of a joyful moment - the birth of a child.

Hydrosalpinx: what is it?

Hydrosalpinx is a disease of the fallopian tubes, the consequence of which is a violation of their patency. The name of the pathology comes from the Latin words, where "Hydro" is translated as a liquid, and "salpinx" means a pipe. The phrase often used by women - hydrosalpinx tubes - is incorrect, just like butter oil. A feature of the disease is the accumulation of fluid (transudate) in the lumen of the fallopian tube due to blockage of the internal and external openings of the oviduct, as a result, it turns into a saccular formation.

Distinguish:

• right-sided hydrosalpinx;
• hydrosalpinx on the left;
• bilateral hydrosalpinx.

It is wrong to use combinations such as acute and chronic hydrosalpinx. This pathology is a complication of the inflammatory process of the fallopian tubes - salpingitis, which can be both acute and chronic.

Diagnosis example: Acute bilateral salpingo-oophoritis. Bilateral hydrosalpinx.

Some anatomy and physiology

The fallopian tube (synonyms: fallopian tube or oviduct) is a paired organ and is presented as a hollow tube with two lumens. The length of the oviducts reaches 10 - 12 cm, and the right tube is somewhat longer than the left. One end of the oviduct opens into the uterine cavity, and the other ends with fimbriae (villi) and opens into the abdominal cavity, not far from the ovary. Through these holes, the abdominal cavity communicates with the internal and external genital organs of a woman, which increases the risk of ascending infection, for example, with vaginitis.

The wall of the oviduct consists of three layers:

• external - represented by the peritoneum and protects the tube from negative influences;
• muscular - formed by muscle fibers and due to which the tube makes peristaltic (contractile) movements towards the uterine cavity;
• internal, covered with ciliated epithelium, the cilia of which move in waves (flicker), which facilitates the movement of a fertilized egg towards the uterus; in addition, the glands located in the mucous layer of the tube produce a secret that maintains the constancy of the internal environment of the oviduct and the viability of the egg, sperm and zygote.

The role of the fallopian tubes

The oviducts are essential for successful conception and implantation of a fertilized egg in the uterus. The functions of the fallopian tubes include:

• with the help of the fimbriae of the funnel of the tube, the egg that has matured and left the follicle is captured (the moment of ovulation);
• the egg moves to the ampullary section of the tube, where spermatozoa are delivered from the uterine cavity;
• maintaining the viability of germ cells (sperms and eggs), preparing for their connection, direct fertilization;
• maintaining the vital activity of a fertilized egg (zygote) in the tube before moving it into the uterine cavity;
• transportation of the zygote into the uterine cavity due to the peristalsis of the oviducts and the increased activity of the cilia of the ciliated epithelium.

The mechanism of development of pathology

Violation of the 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 adhesion formation capture 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 fimbria of the funnel of the tube stick together. When adhesions close both openings of the oviduct, mucus begins to accumulate in the resulting closed space, intensively, 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. With suppuration of the serous-mucous contents of the tube, a pyosalpinx is formed.

In some situations (incomplete soldering of the fimbriae), a “valve hydrosalpinx” is formed, which periodically breaks through due to the pressure of the accumulated fluid. An increase in pressure occurs with a sharp change in body position, straining, in the process of hysterosalpingography. In this case, the transudate is poured into the small pelvis. Emptying the oviduct with "valve hydrosalpinx" occurs systematically. The poured out inflammatory fluid stimulates the formation of adhesions in the pelvis - a vicious circle is formed that supports the existence of hydrosalpinx.

Causes of hydrosalpinx

The formation of hydrosalpinx is due to the closure of the ampullar (middle) part of the fallopian environment, which is facilitated by a local infectious-inflammatory reaction. Infectious agents can enter the oviduct cavity both ascending from the underlying organs of the reproductive system (cervix, vagina, uterus) and descending through the bloodstream (bladder and kidneys, tonsils and intestines, appendix and others). Inflammation can be aseptic and occur in the presence of other gynecological diseases. The formation of hydrosalpinx occurs due to the following reasons:

• inflammation of the tubes, ovaries or appendages (salpingitis, oophoritis, adnexitis);
• inflammation of the uterus (endometritis);
• frequent and indiscriminate change of sexual partners (sexual infections: chlamydia, myco- and ureaplasma, Trichomonas, gonococci and others);
• tuberculosis of the female genital organs;
• wearing an intrauterine contraceptive;
• frequent hypothermia (weaken immunity and activate opportunistic flora);
• abortions and diagnostic curettage of the uterine cavity;
• prolonged vaginitis and vaginal dysbacteriosis;
• inflammation of the cervix and cervical canal;
• external endometriosis (causes aseptic inflammation and the formation of adhesions in the pelvis);
• adenomyosis;
• myomatous node in the area of ​​​​the entrance of the fallopian tube into the uterine cavity;
• sexual infantilism (tubes are thin, long and twisted);
• damage to the oviducts during laparoscopy with the subsequent occurrence of aseptic inflammation.

The following factors predispose to the formation of saccular formation in the tube:

• neglect of the rules of intimate hygiene;
• stress, emotional stress;
• endocrine pathology: diabetes mellitus, thyroid disease (weaken the body's defenses).

But I would like to note that not always transferred and treated salpingitis or adnexitis ends with the formation of hydrosalpinx. With strong immunity and adequate and timely treatment, the inflammatory process in the tube disappears without consequences.

Symptoms

The clinical picture of the described pathology depends on the disease that caused it. With hydrosalpinx, which developed against the background of acute inflammation of the tubes, the symptoms are more pronounced. The patient is worried about febrile temperature, acute, arching pains in the groin (left or right), signs of intoxication: loss of appetite, lethargy and weakness. With the rapid accumulation of transudate in the ampullary section of the tube, the pain is bursting and pulsating.

In the case of chronic salpingitis, accompanied by the formation of hydrosalpinx, patients often do not worry about anything. Often, the only complaint is the inability to get pregnant, and hydrosalpinx is found during an additional examination. But complaints of discomfort in the iliac regions, a sensation of a foreign body in the groin are also possible. If there is a valve hydrosalpinx, then a woman may notice periodic abundant watery discharge from the genital tract (in case of a breakthrough of the formation into the uterine cavity). With the outflow of transudate into the pelvic cavity, adhesion formation increases in it, which is manifested by chronic pelvic pain syndrome. Sometimes the symptoms of saccular tube formation resemble acute surgical pathology (appendicitis, renal colic or intestinal).

Typical signs of chronic salpingitis and formed hydrosalpinx are:

• discomfort or slight aching pain in the iliac region/areas;
• menstrual disorders;
• pathological discharge from the genital tract;
• no pregnancy.

Pregnancy due to hydrosalpinx

Against the background of hydrosalpinx, you can become pregnant, but in case of damage to the tube only on one side. Accordingly, the probability of conception is reduced by 50%. However, with this disease, the risk of tubal pregnancy and spontaneous abortion increases. Ectopic pregnancy is caused by damage to the ciliated epithelium in the affected tube and a violation of its peristalsis. As a result, the fertilized egg stays in the oviduct for 4 or more days, where it implants and continues to develop.

Spontaneous abortion against the background of saccular expansion of the tube is explained by several points:

• mechanical effect: periodically pouring fluid from the valve hydrosalpinx washes the zygote from the surface of the endometrium, preventing it from implanting;
• inflammatory transudate of the hydrosalpinx, getting on the uterine mucosa, causes its damage and the development of endometritis, which makes implantation of the embryo impossible;
• possible toxic effect of the inflammatory fluid on the embryo, which leads to its damage and death;
• the sensitivity of endometrial receptors to female sex hormones decreases, which leads to a violation of the hormonal regulation of the uterine mucosa of the implantation process.

If hydrosalpinx is diagnosed on both sides, then the onset of pregnancy in a natural way is impossible. In such cases, assisted reproductive technologies (IVF) are resorted to, although the effectiveness of in vitro fertilization and subsequent gestation decreases several times (2-5).

If pregnancy nevertheless occurred against the background of an existing saccular expansion of the tube, then it can be interrupted spontaneously in the early and late periods. Therefore, all pregnant women with the presence of hydrosalpinx are at high risk for miscarriage. Treatment of the disease is postponed until the postpartum period.

Diagnostics

Diagnosis of this complication begins with a gynecological examination. When conducting bimanual palpation, the hydrosalpinx can be felt as a tight elastic and oblong formation on the right / left or on both sides. Perhaps the appearance of minor pain on palpation of the appendages or their absence. But with a slight expansion of the oviduct, the doctor may not palpate the formation and prescribe additional research methods:

Ultrasound transvaginal probe

Determine the presence of a saccular formation on one or both sides, located between the uterus and the ovary, its size and shape. It is possible to visualize the septa in the formation (follicular hydrosalpinx). The formation is filled with hypoechoic fluid and has its own thick capsule.

Hysterosalpingography

This method consists in introducing a contrast agent (under pressure) into the uterine cavity through the cervical canal. Then X-rays are taken. Hysterosalpingography allows you to determine the patency of the tubes - the contrast is visualized in the pelvis and identify hydrosalpinx. In the presence of a complication, the fallopian tube looks tortuous and thickened, and accumulated contrast is found in the expanded ampullary section.

Laparoscopy

It is carried out for diagnostic and therapeutic purposes. During a laparoscopic operation, thickened fallopian tubes are revealed, the fimbria at their ends are edematous and hyperemic, and the wall of the tube is thinned and translucent, its cavity is filled with watery contents.

In addition to instrumental methods of examination, it is necessary to pass tests for sexual infections (chlamydia, myco- and ureaplasma, cytomegalovirus, HPV and herpes virus).

Treatment

If a hydrosalpinx is detected, a woman is strongly recommended to undergo treatment, because the longer this pathology exists, the more intense the adhesions in the pelvis are formed, which reduces the chances of conception and increases the risk of miscarriage or ectopic pregnancy. Unfortunately, many patients talk about this disease as not serious (it doesn’t hurt, so it’s not dangerous) and delay the visit to the gynecologist. Sometimes this leads to irreversible consequences: the absolute impossibility of conceiving naturally and the need to turn to IVF.

But how to treat this pathology? Therapeutic measures for hydrosalpinx are carried out in two stages. The first stage of treatment is conservative therapy. If there is an acute inflammatory process of the appendages or an exacerbation of a chronic one. First of all, antibiotic treatment is prescribed. The duration of the course and the dosage of antibacterial drugs are selected individually, taking into account the identified pathogens and their sensitivity to drugs.

The main line of conservative therapy is the stimulation of immunity. For this purpose, immunomodulatory agents are prescribed:

• immunofan;
• licopid;
• imudon;
• thymalin;
• taktivin;
• aloe injections;
• immunal;
• autohemotherapy (intramuscular injection of a woman's own venous blood).

Also, to stimulate the immune system, the intake and parenteral administration of vitamins is indicated. Physiotherapeutic procedures are widely used, although it is impossible to achieve a complete cure for hydrosalpinx and resorption of adhesions with their help:

• magnetophoresis;
• electrolytes (calcium, magnesium);
• electrical stimulation of the fallopian tubes;
• endovaginal vibromassage.

Hirudotherapists are sure that you can get rid of this disease by resorting to the method of treatment with leeches. Such a statement has neither scientific evidence nor confirmed statistical data.

Folk methods

Most patients believe that it is possible to treat hydrosalpinx with folk remedies. Doctors allow the use of folk methods, but only as an addition to the first (conservative) stage of therapy. Traditional medicine will not help get rid of the disease, but only eliminate a number of symptoms: they will reduce pain, somewhat slow down the progression of inflammation and adhesions, and more or less normalize the menstrual cycle. Of the recommended folk remedies, it is permissible to use:

• taking pumpkin, potato and nettle juice (singly or in a mixture);
• microclysters with medicinal herbs (pharmacy chamomile, calendula, oak bark);
• taking a mixture of aloe leaves, butter and honey;
• taking oatmeal;
• taking juniper baths (an infusion of juniper berries and branches is poured into the water, the water in the bath should be warm, but not hot);
• infusion of adonis;
• infusion of a mixture of herbs (chamomile, currant leaf, sage, St. John's wort).

Once again, I would like to remind you that it is impossible to achieve a complete cure for the disease with the help of traditional medicine methods.

Surgery

The second step in the treatment of this complication is surgical intervention. In the presence of hydrosalpinx, treatment without surgery does not make sense. As long as the focus of inflammation in the small pelvis remains, adhesion formation will continue, pain will persist and the chances of fertilization will decrease.

Today, laparoscopy is used as a surgical intervention for hydrosalpinx. Laparoscopic treatment of saccular formation in the tube is the most sparing and effective surgical intervention. In the process of laparoscopy, depending on the condition of the tubes, the age of the patient and her desire to become pregnant, the following types of surgical intervention in the anatomy of the oviducts are performed:

• salpingo-ovariolysis - adhesions around the oviduct and ovary are dissected, their anatomical location is restored, adhesions in the lumen of the fallopian tube are also separated;
• fimbriolysis and fimbrioplasty - the fimbriae of the end section of the tube, which are adjacent to the ovary, are freed from adhesions, the inflammatory transudate is removed from the tube, if necessary, fimbria plastic surgery is performed;
• salpingostomy and salpingoneostomy - they form a new hole in the ampulla of the oviduct or are released from adhesions of the anatomical hole (minus salpingoneostomy - the new hole grows very quickly);
• tubectomy - removal of the tube / tubes (performed in women over 35 years of age or if it is impossible to restore the patency of the oviduct and eliminate the hydrosalpinx).

But even in the case of a successful operation, the preservation of the tube and the restoration of its patency, the oviduct does not function as before. The villi of the ciliated epithelium either lose their mobility, or the epithelium itself atrophies, and the muscle layer is not able to contract in the previous mode, that is, the peristalsis of the tube is disturbed, so patients are included in the risk group for ectopic pregnancy, and the onset of pregnancy is recommended through IVF.

Question answer

Why is this disease dangerous?

The presence of hydrosalpinx several times increases the likelihood of an ectopic pregnancy. In addition, hydrosalpinx almost always leads to infertility. An increasing saccular formation in the tubes may burst or fester (pyovar).

Do I need to observe any restrictions for this disease?

Yes, definitely. Firstly, physical activity should be avoided (vibration, straining, a sharp change in body position: somersaults, bends, jumps). Secondly, avoid excessive activity during intercourse, which increases pain. In addition, it is not recommended to sunbathe and visit the solarium, as well as visiting baths, saunas and taking hot baths, which can provoke an aggravation of the inflammatory process. It is undesirable to swim in the pool and open water, as local hypothermia will also provoke an aggravation. It is forbidden to drink alcohol, including low-alcohol drinks, which suppresses the immune system.

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

With restored tube patency and removal of hydrosalpinx, conception in a natural way and gestation occurs in 60-75%, and the likelihood of an ectopic pregnancy does not exceed 5%. If the tube is removed, IVF efficiency is 30-35%.

Within 3 - 4 weeks it is necessary to refrain from physical activity and observe sexual rest. You should also follow a diet that limits the consumption of spicy, pickled and salty foods, fried and fatty foods, fast food and canned food.

Hydrosalpinx of one fallopian tube leaves the possibility of becoming pregnant after surgery if the second (paired) organ is healthy. However, a diseased tube can be

capable of functioning if cured. What is the probability of a combination of pregnancy and hydrosalpinx if conception has taken place? How to live and is it possible to get pregnant with such a pathology? The features of these problems and ways to solve them are described in the article.

Is it possible to conceive with hydrosalpinx?

The essence of infertility in hydrosalpinx is that the mature egg does not enter the uterus. In order for this to happen, the fallopian tube must perform the actions inherent in it by nature: to capture the egg and keep it in itself for a day. This provides her with the opportunity to meet with the sperm. After 24 hours, the fertilized or unfertilized egg is sent to the uterus.

When the lumen is blocked, fluid accumulates and the organ cannot perform its task. As a rule, with hydrosalpinx, its “cilia” often stick together, as a result of which even the capture of an egg becomes impossible. But if the "cilia" still function, blockage inside the lumen creates a complete obstruction. The only way to clear the path for her is through surgery.

It is in order for pregnancy to occur that a laparoscopic operation is performed, during which the hydrosalpinx is removed. However, it often violates the natural surface of the lumen. After it, the cilia that promote the egg are no longer restored, and scars form on the epithelium. Because of this, even a fertilized egg does not advance, and an ectopic pregnancy occurs.

Treatment options with the ability to conceive a baby

An operation to remove the hydrosalpinx and save the organ can be done to a woman who does not plan a pregnancy in the future. For a woman who wants to get pregnant, the following options for solving the problem apply:

1. Removal of a diseased organ for the sake of a healthy one (you can get pregnant with the help of the remaining paired organ; the chance is 50%).

2. Removal of 2 tubes, if both are affected by hydrosalpinx. For conception after such an operation, the IVF procedure is used.

What threatens the treated organ to future conception?

If, in the hope of fertilization, a woman believes that it is possible to leave an organ treated for hydrosalpinx, it should be understood that conception may not occur. There is no guarantee that the egg will be in a healthy tube. And the treated carries a high risk of ectopic pregnancy.

In addition, there is another danger: with a high probability, you can expect a spontaneous miscarriage in the first weeks of the term. This is due to the very nature of hydrosalpinx:

- with pathology, a lot of fluid (transudate) is formed

- periodically, the transudate breaks the "bag" in which it has accumulated

- the fluid is sent to the uterus and literally “washes out” the attached embryo.

However, there are cases when the embryo manages to stay in the uterus. If a miscarriage does not occur after the first 7 weeks of the term, the chances of enduring the baby become very high. It should also be said that the transudate itself has a negative effect on the embryo, which can die from its effects. In addition, the functional ability of the endometrium is deteriorating. The tissue loses, cannot qualitatively attach the embryo, as a result of which pregnancy does not occur.

From the foregoing, it follows that it is not advisable to refuse surgical treatment. Here it is better to make a decision based on plans to get a healthy pregnancy or not have more children. In the 2nd case, contraception should be used.

Features of the lumen of the fallopian tube

It is important to understand that each organism is individual, and, theoretically, it is possible to become pregnant after getting rid of the hydrosalpinx while preserving the organ. The main thing is that the treatment should be carried out at an early stage of the pathology. Here we are talking about surgical intervention: with the help of laparoscopy, the hydrosalpinx is removed, after which the lumen is restored.

It should be noted that this lumen in a healthy organ is not the same along its length. In the narrowest place - the uterine part - its width is 1 mm. The widest lumen at the ampoule (8-12 mm from one end). This part of the tube is 6-7 cm long, and at the other end the ampulla narrows to 4 mm. Restoration of the lumen gives a chance of having a healthy pregnancy in 5% of cases after the treatment of adhesions. Surgical treatment of a mild degree of hydrosalpinx development makes it possible to have a normal pregnancy in 77% of cases.

An important issue is the timeliness of treatment. How to make the operation on time and not miss the time? If the symptoms do not manifest themselves, it is necessary to visit the gynecologist 2 times a year for preventive purposes. This will prevent not only this pathology, but also many others. Particular attention should be paid to the impossibility of getting pregnant if the couple makes efforts to do this.

IVF - a guarantee of a healthy conception

The only choice for bilateral hydrosalpinx is in vitro fertilization (IVF). The obstruction of both tubes completely eliminates the possibility of becoming pregnant, and thanks to IVF (in vitro conception), you can bear your own baby. However, there are some nuances here: if both pipes are cured, this will not guarantee a normal pregnancy, and the risk of ectopic and miscarriage remains high.

Conditions for IVF

Also, fluid from the fallopian tubes should not be allowed to pass, as it is detrimental to the fetus. That is why the following procedures are a condition for IVF:

– treatment of all inflammatory processes in the pelvic organs

- removal of hydrosalpinxes or complete removal of diseased tubes.

The second condition - the removal of one patient or 2 organs - increases the possibility of conception three times (from 10% to 35%). At the same time, attempts to restore the patency of the lumen do not increase the percentage of probability, but do not reduce it either. It should be noted that after the removal of the tubes with hydrosalpinx, the function of the ovaries does not change to produce full-fledged eggs. This is one of the factors on which the success of IVF is based.