What is Hydrosalpinx?
A hydrosalpinx is a distally blocked fallopian tube that is filled with serous or clear fluid. This occurs because of an injury or infection. This condition is often bilateral and the affected fallopian tubes may reach several centimeters in diameters. The blocked tubes in turn cause infertility. More about the symptoms, causes and treatments for Hydrosalpinx can be known from the following sections of the article.
Symptoms of Hydrosalpinx
Symptoms of hydrosalpinx may vary from patient to patient. However, below are some of the common symptoms we have mentioned that can be generally noted in an individual suffering from hydrosalpinx.
Infertility is the most common symptom of hydrosalpinx and it arises with defective functioning of the fallopian tube. Patients who are not in a state of pregnancy and are without painful symptoms, may remain undetected about the problem.
Lower Body Pain:
Some patients suffer from painful symptoms in their lower part of the body, like their lower abdomen or their pelvis. Hydrosalpinx pain may be recurrent in nature. However, some other patients may be asymptomatic or may not suffer from any symptoms at all.
In certain cases, this condition of hydrosalpinx is associated with abdominal surgery, endometriosis and IUDs. The body’s immune system blocks the injury site with inflammatory cells. This in turn leads to inflammation that gradually heals. However, it leads to a loss of the fimbriae and fallopian tube blockage.
Causes of Hydrosalpinx:
Hydrosalpinx results primarily from a long-untreated infection in the fallopian tubes. A number of situations may cause fallopian tube infection; which include the following:
- Prior ruptured appendix
- The residual effects of a pre-existing or a prior sexually transmitted disease like Chlamydia or gonorrhea
- Excessive buildup of tissue because of endometriosis.
Diagnosis of Hydrosalpinx:
There are a lot of ways to diagnose hydrosalpinx. As fallopian tubes are very tiny, all of these diagnosis methods make use of some form of X-ray or camera so as to clearly view the anatomy. Below are some of the common methods of diagnosing hydrosalpinx:
This is the procedure where a narrow probe is inserted in to the vagina. Ultrasound technology makes use of sonar or high frequency sound waves so as to produce a real-time image of the fallopian tubes. A normal fallopian tube is not visible generally on an ultrasound; however a fallopian tube that is filled with fluid appears larger and “sausage-shaped”. Ultrasound is non-invasive, painless and a brief and initial assessment of the ovaries, fallopian tubes and uterus.
Hysterosalpingogram or HSG:
This is an X-ray examination, during which a small amount of dye is injected in to the uterus and fallopian tubes of the patient. The X-ray is then viewed on a screen as the examination is conducted. As the dye disperses via the uterus, it becomes easy to visualize any blockages. The fluid flows through the fallopian tubes and spills into surrounding abdominal portion, if the fallopian tubes are open. In case of a blockage, such as hydrosalpinx, the dye is not able to exit the fallopian tubes and the tubes appear sausage shaped or distended.
Hysterosalpingogram or HSG is performed in the 2nd week of the menstrual cycle and the entire examination takes about 10 minutes. There may be some side effects of the procedure, and it may involve pain in pelvis or cramping. Ibuprofen, taken before the diagnosis procedure, aids with these side effects. Most women generally resume their activities right after the procedure.
Laparoscopy is a surgical procedure which uses a laparoscope, or a thin and lighted instrument fitted with a small viewing camera. This laparoscope is inserted in to the pelvic area through a tiny incision in the belly button, enabling the surgeon to directly see the fallopian tubes on a viewing screen. In specific cases, this procedure may be used to confirm a previous diagnosis of hydrosalpinx or other conditions; however, because it is a surgical procedure and requires general anesthesia, it is usually not used for an initial diagnosis.
Treatments of Hydrosalpinx:
Surgical Treatments to Repair the Blockage in the Fallopian Tubes:
- Neosalpingostomy: Neosalpingostomy is a surgical procedure which is used to repair a small hydrosalpinx. It makes use of a laparoscope which is inserted surgically in to the abdomen and an incision is made to open the blocked fallopian tube. Recovery from this surgical procedure is relatively rapid and one begins her normal activity in few days of the treatment. Because there is a decline in the ovarian health and quality of egg after the age of 35, reversal surgery is more viable for younger individuals who can afford the additional wait time. Patients who are conceiving after tubal surgery must be very closely monitored for a possible ectopic pregnancy, which is a serious situation where the fetus implants and grows in the fallopian tubes instead of the uterus.
- Salpingectomy: There is one more surgical treatment known as salpingectomy, which is a prophylactic surgery that includes complete removal of the fallopian tube. However, it must be mentioned that it is not a complete curative process. This procedure involves chances of shutdown of the incision and may lead to a recurrence of Hydrosalpinx. This surgical procedure is more effective in the nascent stages of Hydrosalpinx and when there is a small obstruction. It has been noted that this surgical procedure of fallopian tube removal has shown significant results during pregnancy and also in controlling birth rates. However, a complete surgical removal of the fallopian tube has some risks involved with it and should best be performed when the patient is trying to get pregnant via in-vivo fertilization. It must be noted that patients must undergo proper counseling before the surgery.
IVF as a Treatment for Hydrosalpinx:
Most women experiencing significant damage of fallopian tubes are advised to directly more to IVF or Inv vitro fertilization, because of the low success rates with attempts at surgical reconstruction of the tubes and because of the increased risk of ectopic pregnancy.
In, in vitro fertilization, the fallopian tubes can be bypassed entirely. This treatment involves a course of fertility enhancing medication for producing multiple eggs in the ovaries. Eggs are then harvested or removed from the ovaries and combined with the sperm in the laboratory. Then the newly fertilized egg is transferred directly in to the women’s uterus by using a small tube called a Catheter.
Non-Surgical Treatments of Hydrosalpinx:
Pelvic Physical Therapy: This is a therapy that helps in normal removal of the blockages in the fallopian tubes. It involves the massaging of fallopian tubes for opening up the blockage. The success rate of this treatment increases to over 70% when massages are combined with fertility yoga, herbal tampons and natural supplements.
Prevention Against Hydrosalpinx:
Pelvic inflammatory disease is one of the major causes of the formation of hydrosalpinx. So, steps to reduce sexually transmitted disease will lower incidence of hydrosalpinx. Also, because hydrosalpinx is a sequel to a pelvic infection; early and appropriate antibiotic treatment of pelvic infection can help in preventing hydrosalpinx.
FAQs Related to Hydrosalpinx:
Can One Get Pregnant With One Normal Tube and One Hydrosalphinx Blocked Tube?
Yes. It is possible that one can conceive even with just one open fallopian tube. However, with a hydrosalpinx, the delicate environment of the uterus may be affected. This in turn, lowers the pregnancy rates.
What Happens If Hydrosalpinx Is Left Untreated?
It is always important to diagnose hydrosalpinx in its very early stage, as it is often found to result in infertility in future. If the condition is not diagnosed for a long period of time, it may cause a gradual damage of the fallopian tube and it can lead to complete impairment of the fallopian tube. This can affect the free motion of egg or sperm from ovary via the tube. The fluid discharged from the fallopian tube is known to be toxic for the embryo. And when this happens, any treatment for infertility turns out to be ineffectual. Moreover, this also increases the chances of miscarriage.
What is Bilateral Hydrosalpinx?
This is a condition that affects severely both sides of a fallopian tube and causes their inflammation. Most cases of hydrosalpinx are bilateral and results in extension of the diameter of the affected fallopian tubes by several inches.
MedlinePlus. (2021). Hydrosalpinx. Retrieved from: https://medlineplus.gov/ency/article/001505.htm
Cleveland Clinic. (2021). Hydrosalpinx. Retrieved from: https://my.clevelandclinic.org/health/diseases/14762-hydrosalpinx