Verified 06/23/2022 by PasseportSanté
Hydrosalpinx is the cause of blocked fallopian tubes in women. It is often secondary to an untreated sexually transmitted infection that has reached the upper reproductive tract. The result is sterility. Its treatment is necessary in the case of the parental project and before IVF. We are evaluating.
What is hydrosalpinx?
Hydrocephalus (also called in the medical language “fluid dilation of the fallopian tube due to obstruction of the fallopian tubes”) is the cause of obstruction of the fallopian tubes.
The fallopian tubes (or uterine tubes) are a component of the female reproductive system. Their role is to receive the egg from the ovary, and then push it into the uterus. Fertilization generally occurs in the fallopian tubes, i.e. the meeting of the sperm and the egg.
Tubal hydrocephalus, in the vast majority of cases, occurs as a result of a pelvic infection (Chlamydia trachomatis, gonococcus, etc.). In this regard, hydrosalpinx will affect approximately 30% of women with one or more upper reproductive tract infections.
Hydrosalpinx is asymptomatic and usually goes unnoticed. They are rarely responsible for heaviness, pelvic pain, and pain during intercourse. It is usually discovered during a medical examination for infertility because hydrosalpinx significantly reduces a woman’s fertility.
Treatment for hydrosalpinx is only surgical and is often necessary before IVF is considered.
What are the symptoms of hydrosalpinx?
Hydrosalpinx is usually asymptomatic. However, some secret signs evoke feelings such as:
- pelvic pain;
- A feeling of heaviness in the lower abdomen.
- Pain during intercourse, etc.
However, the main sign of hydrosalpinx is female infertility. The infertility balance sheet should make the research possible.
What causes hydrosalpinx?
Hydrosalpinx corresponds to obstruction of the fallopian tubes. The latter is secondary to lesions in marginal cells.
The ridges are located at the ends of the fallopian tubes. When damaged, fluid accumulates in the tubes, which expand and become clogged. There are several factors that lead to this phenomenon:
- an untreated sexually transmitted infection, especially gonorrhea and chlamydia (the most common cause);
- non-gynecological infections (eg complicated appendicitis);
- wearing an IUD or coil;
- Abdominal surgery.
What are the consequences of hydrosalpinx?
There are several consequences of tubal hydrocephalus.
In a woman with hydrosalpinx, the tube that connects the uterus to the ovaries is blocked due to fluid buildup. Therefore fertilization is impossible: the egg is lost and the sperm cannot reach the fusion zone.
IVF failure (IVF)
Hydrosalpinx has been shown to have a demonstrated adverse effect on IVF outcomes, but its exact mechanism is unknown despite multiple hypotheses.2. Surgical intervention should be suggested in case of hydrosalpinx and in case of repeated implantation failure.
Because hydrosalpinx is asymptomatic, the disease can go unnoticed for years. Generally, it is discovered during an infertility examination. Several tests can confirm the diagnosis:
- Hysterosalpingography (a scan of the female reproductive organs that requires the injection of an iodinated contrast product into the uterus);
- pelvic ultrasound (a medical imaging technique that uses ultrasound, it allows you to see the pelvic organs, this examination is done through the internal cavity (transvaginal ultrasound);
- Magnetic resonance imaging (MRI).
These various tests confirm the diagnosis of hydrosalpinx. They also make it possible to determine if only one of the tubes is affected or whether both are infected.
In the case of hydrosalpinx, the cause must be determined. The gynecologist in particular may prescribe additional examinations (urine or pelvic samples and/or blood tests) in order to determine the possibility of a genital infection.
Finally, if the patient is wearing an IUD, consideration should be given to removing it.
What are the treatments for hydrosalpinx?
Regardless of any desire to become pregnant, hydrosalpinx does not require treatment. However, it must be monitored and its possible causes sought and treated (STIs, IUDs, endometriosis).
In the case of an STD, antibiotic therapy is most often prescribed.
On the other hand, within the framework of the parental project and in the presence of infertility, it is necessary to treat hydrosalpinx. Treatment is surgical only and prior to in vitro fertilization (IVF) treatments.
The types of surgery vary according to the patient and the damage:
- Removal of blocked fallopian tube(s) or salpingectomy: This surgical procedure involves sterilizing the patient, but pregnancy by IVF is still possible;
- permanent tubal obstruction or tubal ligation (this surgery involves infertility of the patient, but pregnancy through IVF is still possible);
- Tubal reconstructive surgery or “tubal plastic surgery”: This surgical procedure consists in restoring the permeability of the tubes, which makes it possible to treat infertility.
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