Hydrosalpin of the fallopian tubes on the left and on the right

When a woman turns to a gynecologist with a problem - for example, with infertility, then she is often diagnosed with a pathology such as hydrosalpinx. This is a disease in which there is a tubular obstruction due to localized accumulation of fluid effusion.

What is dangerous hydrosalpinx?

The health of the reproductive system directly affects the condition of the body as a whole. This also applies to the problem of hydrosalpinx: the disease, first of all, prevents the onset of pregnancy, and with successful conception creates the danger of miscarriage, ectopic pregnancy, fetal fading. If a woman does not plan to have children, her pathology is not so harmless for her: the development of such complications as the rupture or torsion of the tube, the spread of infection, etc. It is believed that hydrosalpinx is a "slow-action bomb": a woman can live with with this diagnosis, without suspecting anything. However, at one point - for example, against a sharp weakening of immunity, the process can be complicated by suppuration, or by another reaction, which will require urgent surgery - already to save the patient's life.

Doctors are united in their opinion: if there is such a diagnosis, then everything must be done to get rid of pathology. An exception can be only a small-sized pathological focus that does not cause problems to the patient, and not accompanied by any painful symptoms. But even conservative therapeutic measures should be applied to such an insignificant education.

Epidemiology

The most frequent consequence of hydrosalpinx is infertility, so a significant proportion of patients with this pathology subsequently resort to the procedure of in vitro fertilization. Among all women who are preparing for assisted reproductive procedures, hydrosalpinx is recorded in 10-30% of cases.

If a woman has this pathology within a single tube, her chances of self-conceiving are reduced by 50%, and in the bilateral process, they are completely impossible. When carrying out IVF, such women should take into account that the embryo is implanted about 4 times less often. In addition, they have an increased risk of miscarriage at different stages of the process, or the development of an ectopic pregnancy.

Causes of the hydrosallpax

The underlying cause of hydrosalpinx formation is an inflammatory process called salpingitis (or adnexitis). In turn, the inflammation itself develops under the influence of other activating factors. We list the most common risk factors for the emergence of pathology:

• exposure to low temperatures with a simultaneous decrease in immunity;
• endometriosis;
• spontaneous and medical abortion;
• any surgical interventions on the pelvic organs;
• infectious and inflammatory processes in the urinary system;
• use of an intra-matic spiral;
• ignoring the use of condoms, promiscuous sex life;
• inflammatory process in the uterus;
• myoma;
• presence of adhesions in the small pelvis;
• imbalance of the vaginal flora.

Pathogenesis

Disturbance in the tubes of the uterus according to the variant with the development of saktosalpinks occurs due to the adhesive process, which, in turn, becomes the result of inflammatory and other pathologies in the small pelvis. In the tube cavity, connective tissue proliferation occurs, with the formation of distinctive septa and pseudocystic formations. The inner tube lumen gradually decreases, until absolute obstruction is achieved on a separate site.

There is a disorder of lymph flow and blood flow in the affected areas of tissues, and in the newly formed cavity a mass is gradually accumulated, the composition of which is liquid mucus discharge, serum and intercellular fluid.

As the cavity is filled with abnormal fluid, the tube in this area stretches, and the tissues lose their shape and become much thinner.

Liquid contents may sporadically out of the pipe, or may be absorbed. But the presence of adhesions and the current process of inflammation leads to a recurrence of the hydrosalpinx.

In most patients, hydrosalpinx occurs as a result of an inflammatory reaction in the uterus or appendages, as well as diseases that are sexually transmitted. The risk group is also attributed to women who have ever had any surgical intervention in the pelvic area - for example, appendicitis, endometriosis, etc.

Symptoms of the hydrosallpax

At small volumes of a pathology the first signs can be weakly expressed, or are absent at all. Such formations are found by chance - for example, during routine diagnostics. If the tube is stretched under the pressure of a large amount of effusion, then there are symptoms of discomfort. They are manifested in the form of pulling and pressing sensations in the lower-external quadrant of the abdomen, as well as in the form of permanent pain in the pelvic region. The temperature with hydrosalpinx can be subfebrile, or does not exceed the normal range. If there is a drainage process, then the woman observes episodic discharge with hydrosalpinx: the liquid is watery, it is released from the genital tract in a sufficiently large volume.

In the acute course of the disease, an increase in temperature is observed up to about 38.5 ° C. Pain in hydrosalpinx pulsating, expressed, with spreading to the groin area. A sharp onset often causes the illness to be taken for an attack of appendicitis or colic.

In the chronic course of the disease, obstruction causes reproductive harm. The lumen of one or two pipes is closed, which prevents the egg from entering them. With the defeat of two pipes pregnancy is considered impossible.

The pulling sensations in the lower abdomen with bilateral hydrosalpinx become a frequent cause of the patient's treatment to the doctor. However, more often women are referring to the impossibility of conception: even if the tube gleam does not overlap completely, pathology affects the ciliated epithelium, mucous tissues, leads to atrophic changes in the musculature. Disrupted pipe motor skills often become the main factor in the development of ectopic pregnancy.

Monthly with hydrosalpinx usually do not change, since the disease does not affect the functional capacity of the ovaries. Some women have severe pains a week before the onset of menstrual bleeding, and also in the first three or four days from the start of the menstrual cycle.

Psychosomatics in hydrosalpinks

With idiopathic etiology of the disease, doctors do not exclude the psychosomatic scheme of its development. Not so long ago, fear, stress, depression became the main factor of psychosomatic pathology. For example, it is not uncommon for a woman to be ill and, indeed, ill. Psychologists point to the presence of sometimes unrecognized, and from this even more effective fears. "Will I succeed in getting pregnant? Will I be able to bear the baby? Will any unforeseen diseases become a hindrance? "Such thoughts can play a decisive role in the mechanism of the development of the disease.

Having a pronounced and unconscious phobia about his health and well-being, a person subconsciously "programs" himself for ailment, and even for its consequences. As a result, a disease occurs, and fear becomes even more, inflated by constant attempts to become pregnant, etc.

The stressful situation becomes dominant, and the morbid condition is gradually exacerbated. Over time, the fear of being unable to conceive and endure a child is added, and the emotional state of a woman is depressed more and more.

What to do? It is almost impossible to overcome the psychosomatic disease independently. Therefore, you should consult a qualified psychologist - preferably, with someone who inspires confidence from the first word. If there really is a so-called psychological block, the specialist will be able to detect internal factors that contribute to the development of the disease and prevent healing.

Stages

It is accepted to distinguish acute and chronic stage of the disease.

Acute hydrosalpinx is manifested by such signs:

• intensive discharge into the tube of serous fluid;
• increase in temperature indicators;
• general weakness, increased sweating;
• pain in the lower segment of the abdomen, with possible irradiation in the groin;
• frequent palpitations.

Chronic hydrosalpinx in most cases proceeds imperceptibly, with a slow increase in symptoms. Sometimes a woman can complain about sighing pains in the area of the external genitalia.

Forms

According to the character of the morphological signs of the hydrosalpinx of the fallopian tubes, there are:

• single-chambered, with the formation of a spindle-shaped, rounded or S-shaped neoplasm, in which the length is 2-3 times the width;
• multi-chamber, with the presence of 2-8 closed cavities, arranged in the form of chain links.

With a weak activity of the adhesive process and incomplete closure of the tube, fluid can escape from the neoplasm to the uterus or into the small pelvis. In this case, the diagnosis is made of "valve hydrosalpinx," which is also referred to as "draining". Draining hydrosalpinx is often accompanied by the appearance of massive fluid secretions from the genital cleft.

By the degree of involvement of the tubes of the uterus, a one-sided hydrosalpinx is excreted, in which only one of the tubes is affected, as well as a bilateral hydrosalpinx - the most complex lesion of two tubes at a time. The latter option, fortunately, is much less common.

Pipes of the uterus is a paired organ. Each tube is a hollow double-lumen tube that emerges from the uterine cavity and terminates in fimbriae that surround the ovum. These tubes are located to the right and left of the uterus, so there may be a right-sided and a left-sided hydrosalpinx. According to some statistical data, it is believed that the hydrosalpinx on the right is more common.

Complications and consequences

The disease can lead to a lot of negative consequences for the patient - especially if it is found already at a late stage of development. The doctor's task is to prevent the appearance of the following complications:

• deformation of the uterine organ, its deviation to the posterior, bend due to adhesive edema;
• imbalance of the vaginal flora associated with a weakened immune defense;
• violation of the integrity of the affected pipe;
• ectopic development of pregnancy;
• formation of an abscess;
• simultaneous intestinal damage;
• infertility.

Consider other possible consequences of the disease on the example of frequent patient questions:

• Inflammation of hydrosalpinx - how to recognize it?

If the pathology exists for a long time and does not show any symptoms, then the woman may not know about the problem. However, with an increase in education, an inflammatory reaction begins with the further development of the abscess. This complication is accompanied by the accumulation of purulent secretions in the encapsulated cavity. Thus the woman complains of a heat and strong pains in the field of a small basin, with possible or probable distribution in area of external genitals.

• Can it happen that the hydrosalpinx has dissolved itself?

The size of the capsule can be several centimeters. At the same time, the larger these dimensions, the less likely that education will resolve. Small foci, indeed, are prone to independent resorption - but only if their diameter does not exceed 10 mm. By the way, "missing" capsules can appear again - that is, recur.

• How likely is it that a repeated hydrosalpinx will form?

To avoid relapse, first of all, you need to eliminate the cause of the appearance of fluid education. The most common cause is inflammation, which can be eliminated medically. However, the adhesions that formed as a result of the inflammatory reaction can be removed only surgically, so conservative treatment will not protect against the re-emergence of pathology.

After operative dissection of adhesions, the probability of relapse is reduced to a minimum, but there is a risk of other complications - for example, an ectopic pregnancy. Therefore, the decision on what treatment should be carried out, the doctor takes individually.

• The hydrosalpinx burst and the tube, how is this possible?

1. Education in itself is unlikely to be able to break through the appendage. But with the follicular variant in combination with a number of concomitant factors, this complication is indeed possible:
2. with simultaneous inflammation of the adnexa;
3. in tubal pregnancy;
4. with a purulent inflammatory process in the tube walls;
5. with a rapid increase in follicular formation.

• Hydrosalpinx torsion - what is it?

Torsion is possible, both in the presence of pathology in the pipes, and without them. However, in patients with hydrosalpinx, this complication occurs in 10-20%. The provoking factor is sudden movements, intense sports, abdominal injuries, sudden weight lifting, etc. The pathology most often manifests itself in the picture of an acute abdomen: sudden or gradually increasing pains that give in the groin, back. Many people experience nausea, bloating, a malfunction of the monthly cycle. As a rule, severe symptoms are present for 2-7 days. Treatment of torsion - operative.

• Can hydrosalpinx be reborn as a cancer?

By itself, the capsule, as a rule, can not cause cancer. However, the chronic inflammatory process, against which pathology is formed, is considered a predisposing factor in the development of the tumor. Thus, a prolonged course of adnexitis and salpingitis in patients older than 45-50 years significantly increases the risk of formation of cancer complications.

• Is hydrosalpinx dangerous in menopause and postmenopausal women?

The disease is dangerous in all ages, since complications can develop in any patient and at any time. The fact that pathology should only be treated in women of fertile age is a mistaken opinion.

Hydrosalpinx and pregnancy

If the patient plans to become pregnant in the future, then she should definitely decide to perform laparoscopic surgery. With the help of laparoscopy, it is possible to achieve the restoration of tubal patency, however, unfortunately, often the natural tubular function still suffers. After intervention, the motorism of the tubes deteriorates, the number of receptors providing sensitivity to basic sex hormones, such as estradiol and progesterone, decreases. All these processes together can lead to tubal pregnancy.

With unilateral hydrosalpinx, conception can occur through a healthy tube. But the untreated inflammatory process can adversely affect the course of pregnancy - for example, fetal development may fade. Given this, doctors are not advised to plan a conception against the background of the existing hydrosalpinx.

With a two-way process, a woman can not become pregnant on her own. In such a situation, after laparoscopic removal of the tubes, the patient is prepared for the procedure of in vitro fertilization.

Diagnostics of the hydrosallpax

Suspecting the presence of hydrosalpinx, the doctor will conduct a more thorough diagnosis, which will determine the true state of the reproductive organs. Usually, even during a two-handed study, a gynecologist can feel a tight, tight tumor, more often in one direction. During the palpation, the patient may feel uncomfortable.

Blood and urine tests do not provide exhaustive information on the presence of hydrosalpinx, but may indicate that there is an inflammatory process in the body or violations of the folding blood system. Such studies are only an addition to other diagnostic procedures.

Instrumental diagnostics is the most important stage for determining pathology. Usually it includes the following procedures:

• Ultrasound with transvaginal sensor - helps in finding hydrosalpinx, clarifying its location, shape and size;
• hysterosalpingography - allows you to determine the presence of patency in the pipes.

The most reliable method of diagnosis is laparoscopic surgery, which can simultaneously become a curative procedure.

• Hydrosalpinks on ultrasound should be considered on a certain day of the cycle - preferably from 5-6 to 7-9 days. Pathology manifests itself in the form of fluid accumulation in the tube cavity: a new formation with liquid contents localized in the gap between the appendage and the uterus becomes visible. Neoplasm can be present in one tube, or at once in two.
• Hydrosalpinks on MRI can be considered in more detail, therefore the procedure of magnetic resonance imaging in gynecology is considered more informative than ultrasound. Minus the procedure - it's its cost, but in the end, the costs justify themselves, as the doctor gets the opportunity to carefully consider the pathology. The only more informative method than MRI is laparoscopy.

Differential diagnosis

Differential diagnosis is necessary for an adequate diagnosis, first of all, because the initial signs of malignant formations often resemble the hydrosalpinx picture. Therefore, before proceeding to treatment, it is necessary to make a diagnostic laparoscopy with a biopsy.

With ultrasound, there may be a problem in recognizing pathologies such as a cyst or hydrosalpinx with a single chamber. A single-chamber capsule of the correct oval shape actually looks like an ovarian cyst. However, this happens rarely: the configuration of the capsule is often still incorrect, with the predominance of longitudinal size. In other situations, the hydrosalpinx or paraovarian cyst is differentiated only during surgical intervention.

• What is the difference between hydrosalpinx and saktosalpinx?

When talking about the sactosalpinx, we have in mind a general term applied to all tubal pathologies associated with the formation of cavity formation with fluid effusion inside. Hydrosalpinx is just a kind of saktosalpinx, suggesting that the accumulated liquid has a serous character. In addition to this, there is also a pyosalpinx, characterized by the presence of pus inside the cavity.

Many diseases often coexist together, and this greatly complicates the diagnostic process. Hysterosalpingography is successfully used for differentiation. This method is based on the introduction of a contrast liquid into the tube lumen, which, under the influence of radio waves, begins to emit light in a certain wave length. With the help of hysterosalpingography, it is possible to differentiate the adhesion process, salpingoophoritis or hydrosalpinx.

Treatment of the hydrosallpax

To medical procedures resorted immediately after diagnosis. Conservative therapy can be used in women who already have children and do not plan to replenish in the future, as well as with a weakly expressed hydrosalpinx. First and foremost, such treatment is aimed at stopping the inflammatory process, so antibiotics become the first drugs prescribed. When choosing a drug should be based on the resistance of bacteria and the type of pathogen.

More details about the methods of treatment hydrosalpinks read in this article.

Prevention

Hydrosalpinx does not have specific methods of prevention. However, the application of general rules recommended by gynecologists will avoid many diseases, including the one in question.

We list these important rules:

• It is necessary to visit the doctor in time when there are any negative signs on the part of the reproductive system.
• Do not forget about observing the rules of personal hygiene, especially during menstrual bleeding.
• It is necessary to refrain from promiscuous sexual life, and also not to forget about the use of condoms.
• An important preventive criterion is the maintenance of a healthy lifestyle, with the exclusion of bad habits.

Forecast

If the treatment with hydrosalpinx was successful, the patency was restored, and the adhesive process was eliminated, then the functionality of the pipes would still be impaired - the villous cover of the mucosa loses the necessary motility, the progress through the pipes becomes intermittent.

If women underwent a fimbria and salpingoovariolysis treatment, they are at risk of developing an ectopic pregnancy.

If the patency of the affected tube was restored and the acute hydrosalpinx was successfully removed, then natural conception with further bearing becomes possible in 70-80% of cases. In this case, the risk of ectopic pregnancy is estimated at about 5%.

Is it possible to exercise with hydrosalpinx?

Sport with the diagnosis of hydrosalpinx is possible, but it is necessary to carefully weigh the load. Allowed easy exercises, stretch marks, limb movements. The restriction concerns the loads on the muscles of the abdominal press. It is also undesirable to lift weights, perform high-intensity exercises (jumps, vibrations).

The possibility of fitness, athletics, cycling is better discussed with your doctor.