Hydrosalpinx

A hydrosalpinx is a damaged fallopian tube that is filled with fluid. When a previous infection injures a fallopian tube, it often causes the end of the tube to close. Glands produce a clear, watery fluid inside the tube that would normally be secreted and then reabsorbed; however, damaged tubes cannot reabsorb this fluid, so it builds up. Once the fallopian tubes are completely blocked, pregnancy is nearly impossible.

Causes

A hydrosalpinx is usually caused by a pelvic infection or inflammatory disease that spread through the cervix and uterus to the fallopian tubes. These types of diseases, such as gonorrhea and chlamydia, can cause sever symptoms, mild symptoms or no symptoms at all, and if left untreated, they can cause significant damage to the reproductive organs. Scar tissue, IUDs, endometriosis, childbirth and abortions can also cause a hydrosalpinx.

A hydrosalpinx can be one-sided, but infections usually affect both tubes and cause significant damage. For women with a hydrosalpinx on both sides, the only possible way for them to conceive "naturally" is through surgery.

Complications

Infertility is not the only result of a hydrosalpinx. It can also decrease a woman's chances of undergoing successful cycles of fertility treatment, even those that don't require use of the fallopian tubes. Fertility drug therapy may worsen the condition by causing even more fluid build-up in the fallopian tubes, since they are responsive to the hormones produced by these kinds of medications. This built-up fluid can be expressed out of the tubes and into the uterus, which may be toxic to a developing embryo or make it difficult for implantation to occur. Researchers are still conducting studies to determine the effects of tubal fluid spilling back into the uterus. One study found that the risk of miscarriage is doubled in women with a hydrosalpinx.

A hydrosalpinx can also be hazardous during fertility evaluation and treatment because it is vulnerable to re-infection. Some treatments, such as insemination and embryo transfer, may inadvertently introduce bacteria into the tubes and result in a serious infection. Salpingitis, the medical term for an infection in a hydrosalpinx, may require emergency surgery and hospitalization. Diagnosis

Below are several ways a doctor can evaluate and diagnose a hydrosalpinx.

Treatment

A hydrosalpinx can be treated with several laparoscopic procedures. During one of these, known as a neosalpingostomy, an incision is made at the end of the hydrosalpinx and the edges are folded back, leaving the tube open. Unfortunately, hydrosalpinx has a high recurrence rate, so the tube often closes up again.

In young patients with minimal tubal damage, a laparoscopic salpingectomy may be done. In this procedure, the entire fallopian tube is removed. Once it is removed, however, there is no way to replace it, which could complicate a future pregnancy. Because the fallopian tubes and ovaries share a part of the blood supply, destruction of one could affect the other.

Women who have a hydrosalpinx and wish to undergo in vitro fertilization are usually urged to consider laparoscopic surgery prior to their IVF cycle. Studies have shown that if the hydrosalpinx is surgically removed before a woman undergoes IVF, she can expect similar success rates to a woman who has normal fallopian tubes and undergoes the same form of treatment.

All surgical treatment options and their possible complications should be discussed between a woman and her doctor before making any final decisions.