Hydrosalpinx

                                    Hydrosalpinx


Definition

Hydrosalpinx is the blockage of a woman’s fallopian tube caused by a fluid buildup and dilation of the tube at its end. Most often it occurs at the fimbrial end of the tube next to the ovary, but it can also occur at the other end of the tube that attaches to the uterus. The term hydrosalpinx comes from Greek, with hydro meaning water and salpinx meaning tube.
Blocked fallopian tubes are one form of tubal factor infertility. When the fallopian tube is blocked, the cells inside the tube secret fluid that can’t escape, dilating the tube. This prevents fertilization – and thus pregnancy – by blocking an ovulated egg from moving from the ovary to the fallopian tube for fertilization by the sperm. If an ovulated egg is somehow able to connect with a sperm for fertilization, the hydrosalpinx would still likely block the resulting embryo from traveling to the uterus for implantation and pregnancy. It can also potentially cause a dangerous ectopic pregnancy, in which the embryo implants outside the uterus, most often inside the fallopian tube, and results in a life-threatening situation.

Types

The types of blocked Fallopian tubes are normally categorized depending on the location of the tube affected. They are;
Midsegment tubal obstruction
This occurs in the ampullary and it normally results from tubal ligation damage. Tubal ligation is a surgical procedure to prevent future pregnancies. The procedure has its own risks, but many women who opt for it end up requiring a correction when they change their minds
Proximal Tubal Occlusion
This involves the Isthmus and normally results from infections after an abortion, miscarriage, PID, caesarean section and some birth control procedures can block the tubes
Distal Tubal Occlusion
This type affects the end part near the ovary and hydrosalpinx is the major cause of the blockage.

Risk factors

Damage to fallopian tubes can result in infertility without any obvious signs or symptoms. Your risk for having a hydrosalpinx or blocked tubes increases with each of the following:
  • Appendicitis
  • Endometriosis
  • Previous pelvic surgery
  • Sexually transmitted disease
  • Pelvic Adhesions
The diagnosis changes to hydrosalpinges when both tubes are damaged. If you have experienced trouble getting pregnant, or have pelvic pain and unusual vaginal discharge, Dr. Douglas will want to rule out the possibility of hydrosalpinx or hydrosalpinges.

Causes

The most common cause of blocked fallopian tubes is a pelvic inflammatory disease (PID). PID is the result of a sexually transmitted disease, but not all pelvic infections are related to STDs. Also, even if PID is no longer present, a history of PID or pelvic infection increases the risk of blocked tubes.
Other potential causes of blocked fallopian tubes include:
  • Current or history of an STD infection, specifically chlamydia or gonorrhea
  • History of uterine infection caused by an abortion or miscarriage
  • History of a ruptured appendix
  • History of abdominal surgery
  • Previous ectopic pregnancy
  • Prior surgery involving the fallopian tubes
  • Endometriosis

Symptoms

Blocked fallopian tubes symptoms are very rare. The symptoms include
  • Strong to mild abdominal pain
  • Fever
  • Painful periods
  • Strange looking or smelling vaginal discharge
  • Feeling pain while having sex or passing urine, but because many women ovulate, fallopian tube blockage can go ignored until a woman wants to get pregnant.

Complications

Surgery to open the fallopian tubes carries the same potential complications as any surgery. These include:
  • Infection
  • Creation of more scar tissue
  • Damage to organs
  • Bleeding
One risk of pregnancy after surgery is an ectopic pregnancy, meaning that a fertilized egg gets stuck outside of the womb, often in a fallopian tube. The egg will not develop, and there can be a risk to a woman’s health.

Diagnosis

There really are no outward signs that will let you know if you are suffering from blocked fallopian tubes. If you have ever suffered from the pelvic inflammatory disease, there is a 15% -50% chance that your tubes are blocked.
The primary indicator that there is a blockage is an inability to conceive. Fortunately, there are diagnostic tests that can detect any abnormalities or blockages if there is evidence of some type of blockage to the tubes. Here are details on how blocked fallopian tubes are diagnosed…
Hysterosalpingogram (HSG)
Hysterosalpingogram is an X-ray test, using a contrast dye to view any obstruction in the fallopian tubes. The dye is inserted through a thin tube that is placed up through the vagina, into the uterus. Filling the uterus with this dye will then spill into the fallopian tubes. X-rays are then taken to determine if there is an injury or abnormal shape of the uterus and fallopian tubes, including obstruction in the tubes. This test is the number one test performed to determine if there is a blockage in the fallopian tubes.
Chromotubation
This test is similar to hysterosalpingogram because chromotubation includes dye being passed into the uterus and fallopian tubes as well. This test is performed during laparoscopy so that doctors can see the dye spilling from the fallopian tube. The dye used for this procedure cannot be seen on an X-ray, it is blue in color. This test is considered the most reliable way to determine fallopian tube blockage but does require surgery. It is not the initial test performed unless there is another reason to perform surgery such as chronic pelvic pain.
Sonohysterography
This is a non-invasive procedure where ultrasound imaging is used to determine if there are any abnormalities of the reproductive organs. This type of test is not always a reliable way to determine fallopian tube blockage since the tubes are so small and spillage of the fluid cannot always be seen on ultrasound. This test may help to determine hydrosalpinx or other issues such as uterine fibroids.

Treatment

For Single Tubal Blockage: This is not difficult to cure. It does not include complex process. Fertility specialists normally recommend powerful fertility drugs to patients to improve their probabilities of ovulating on whichever side the tube is open without blockage.
For Both Tubes Blockage: Here generally the fertility drugs are not satisfactory when both tubes are blocked. Here, laparoscopic surgery is the greatest desirable choice to overcome the problem. The chances of success depend on the age of the women if younger then better. Laparoscopic surgery either clears the blockage or splits out tissue that is affecting the issues.
Common laparoscopic procedures include:
  • Tubal ligation reversal involves surgically reopening, untying or reconnecting a woman’s fallopian tubes that have been intentionally tied off or closed from a tubal ligation. Tubal ligation reversal can enable a woman to become pregnant again and is generally performed through minimally invasive robotic surgery.
  • Salpingectomy is a surgery to address hydrosalpinx (a buildup of fluid in the fallopian tubes) by removing scar tissue around the tube or removing the damaged part of the tube that is causing the fluid buildup.
  • Tubal removal may also be the best option to treat infertility. Although removing a fallopian tube sounds drastic, the inflammation from a damaged tube is a constant irritation in the pelvic cavity that can interfere with fertility. By removing the damaged tube causing inflammation, there is a better chance of getting pregnant through the remaining healthy fallopian tube.
  • Adhesiolysis is the simultaneous use of laparoscopy and hysteroscopy to remove adhesions or blockages from the origin of the fallopian tube, where it exits the uterus. A fertility surgeon inserts imaging die into the woman’s fallopian tubes to visualize the blockage and then taps the blockage away from the end of the tube using a wire guide through a slender tube.
IVF: IVF is the most effective modality treatment for blocked fallopian tubes and frequently the last option for patients who wish to get over this sickness and become pregnant

Prevention

Preventive measures that you could take:
  • Avoid drinking and smoking.
  • Practice some meditation. This can help lower your stress levels.
  • Sign up for yoga classes, or do it at home. A few poses that can help boost the health of your reproductive organs are the butterfly pose and bridge pose.
  • Avoid excessive consumption of junk foods. Include foods like fresh fruits, green leafy vegetables, and coconut oils. These are rich in antioxidants. Citrus foods, eggs, mangoes, zucchini, and spinach are rich in carotenoids, which help your enzymes and circulation as well.
  • Increase your intake of Vitamin C – it helps ease out inflammation.
  • Use herbal tampons. These contain herbs like goldenseal and Dong Quai, which can help clear out your fallopian tubes.

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