Explaining Hydrosalpinx: Overview, Causes, Diagnosis, and Treatment

Photo by: Bigstockphoto
Photo by: Bigstockphoto

Hydrosalpinx is a medical condition that affects the fallopian tube. This condition occurs when the fallopian tube is blocked and filled with fluid. The accumulation of fluid could be caused by trauma or an infection. To understand the condition, you need to learn how the entire reproductive system works.

The fallopian tube “catches” the unfertilized egg released by the ovaries. Once the egg is in the right position, it waits until a sperm will fertilize it. This reproductive process happens every month. After an egg is fertilized, it travels to the uterus. If the fallopian tube is damaged in any way, the egg cannot be fertilized.

When the fallopian tube is inflamed, the delicate finger-like fimbria that extends all the way to the ovaries is destroyed. Even if the inflammation goes down and fallopian tubes healed from the inflammation, the fimbria is still destroyed. The fimbria is responsible for carrying the egg to the sperm. Once destroyed, the fimbria will lump together, closing the tubes for good. When the tubes are closed, the clear liquid in the fallopian tubes cannot be flushed out.

When the tubes are blocked, the shape is distorted, giving an engorged, sausage-like appearance. Hydrosalpinx often leads to infertility. The condition affects only a single tube. If both tubes are affected, this condition is called hydrosalpinges.

Causes of Hydrosalpinx

Hydrosalpinx is typically caused by an untreated infection in the fallopian tube. A sexually transmitted disease (chlamydia and gonorrhea), excessive tissue build up due to endometriosis, or a ruptured appendix could cause the infection.

Diagnosing Hydrosalpinx

Diagnosing this condition is done using three methods: ultrasound, hysterosalpingogram, or laparoscopy:

Ultrasound

A narrow tube is inserted into the vagina. It will emit sonar or high-frequency sound waves to generate a real-time image of the fallopian tubes. A normal fallopian tube will not register on an ultrasound. But a fluid-filled one will be visible.

Hysterosalpingogram or HSG

This 10-minute test starts by injecting dye into the uterus and fallopian tube. Then, an X-ray machine will assess the dye as it spreads out in the uterus. From here, the blockage is revealed and visualized. If the fallopian is not blocked, the fluid should flow through the tube, spilling into the abdominal area. If the dye is unable to exit the fallopian tube, then your doctor will make his diagnosis.

Laparoscopy

This surgical procedure uses a laparoscope. A laparoscope is a thin, lighted instrument fitted with a camera. The laparoscope is inserted into the pelvic area via a tiny incision. Once it is in the right position, the laparoscope will provide a real-time video of the fallopian tube. The surgeon can see if the tubes are blocked.

Treating Hydrosalpinx

Surgical Reconstruction

There are cases wherein surgical repair could reverse the effects of hydrosalpinx. If the blockage is small, the tissues are repaired to allow pregnancy to occur naturally. This procedure is called neosalpingostomy. During the procedure, a laparoscope is surgically inserted into the midsection. An incision is made to open the blocked fallopian tube. Recovery from a neosalpingostomy is relatively quick. In fact, a patient can go back to her normal, day-to-day activities within a few days after surgery.

Do note that a neosalpingostomy is recommended to younger patients. Ovarian health and egg quality usually decline after the age of 35.

In Vitro Fertilization or IVF

Because success from a neosalpingostomy is not guaranteed, most patients turn to IVF to get pregnant. In vitro fertilization is a process wherein the egg is harvested and fertilized in a lab. Then, the fertilized egg is inserted back into the woman’s uterus using a catheter.

To increase the success rate of IVF, the damaged fallopian tube must be removed before the treatment. Blocked, fluid-filled fallopian tubes increase the risk of an infection after transplanting the fertilized egg.


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