What is Hydrosalpinx?
Hydrosalpinx is a medical term meaning the blockage of the fallopian tube also known as the oviduct or uterine tube, by a watery fluid. The word Hydrosalpinx is of Greek origin meaning – Hydro means water and salpinx means fallopian tube.
the fallopian tube is a pair of long narrow ducts located in the human female abdominal cavity that transport male sperm cells to the egg, provide a suitable environment for fertilization, and transport the egg from the ovary, where it is produced, to the central channel of the uterus. Each fallopian tube is 10–13 cm (4–5 inches) long and 0.5–1.2 cm (0.2–0.6 inches) in diameter.
The fallopian tube blockage can occur at both or one end of the tube. there is the Fimbriae end, the part that connects the tube with the ovary, when this is blocked it prevents ovulated eggs from entering the fallopian tube. Also, when the Intramural end is blocked that is part that connects the tube to the uterus, Even if the egg manages to connect with sperm and fertilize, the hydrosalpinx would still block the embryo from connecting to the uterus for implantation and pregnancy. This would lead to implantation outside the uterus, mostly in the fallopian tube, thereby causing ectopic pregnancy, a serious life-threatening situation.
The tube secrets fluid that helps to transport the sperm and egg to keep them alive, so when this blockage occurs and there is no movement of the fluid the cause and dilation of the tube damage the tube. According National Institutes of Health (NIN) Hydrosalpinx impact negatively the result of women who undergoes Reproductive treatment like in-vitro fertilization (IVF) by reducing the success rate to 50%. So it’s advisable to surgically remove Hydrosalpinx before IVF.
If one tube is affected typically the other tube has a high potential of being affected too, Even if the embryo through the unaffected tube enters the uterus there is a high risk arising from that because the dilated tube will leak substance into the uterus which will lead to complication.
Causes of Hydrosalpinx
Several factors could lead to hydrosalpinx such as;
⦁ Previous Sexual Transmitted diseases (STDs) or if untreated for a long time
⦁ Pelvic Inflammatory disease or if untreated for a long time
⦁ Prior ruptured appendicitis
⦁ Previous surgery
Symptoms of Hydrosalpinx
Most women do not have any symptoms except for the inability to get pregnant. In some women, an ectopic pregnancy can be a sign or symptom of hydrosalpinx. Occasionally, some women may complain of regular or constant pain in their pelvis or lower belly, which may get worse during and after their period. A vaginal discharge can also be associated with this condition.
There are several ways A doctor can use to properly diagnose hydrosalpinx such as;
⦁ Ultrasound: This is a transvaginal ultrasound known as sonohysterosalpingography, a narrow probe is inserted into the vagina. Ultrasound technology uses sonar or high-frequency sound waves to produce a real-time image of the fallopian tubes. A normal fallopian tube is usually not visible on an ultrasound; a tube filled with fluid will appear larger and ‘sausage-shaped.’ Ultrasound is brief, non-invasive, and painless. Though this usually indicates a severe level of hydrosalpinx.
⦁ Hysterosalpingogram (HSG) (x-ray): This is a type of X-ray used to examine the inside of fallopian tubes to help diagnose a blockage, A little quantity of dye is injected into the fallopian tube which enables the doctor to see the fallopian tube through the x-ray screen. If the fallopian tubes are open, the fluid flows through the tubes and spills into the surrounding abdominal area. In the event of a blockage such as a hydrosalpinx, dye is unable to exit the fallopian tubes, and tubes will appear distended. HSG is performed in the 2nd week of the menstrual cycle (i.e. after menstrual bleeding has stopped but before ovulation). The entire exam takes about 10 minutes. Side effects, if any, may involve pelvic pain or cramping. Ibuprofen taken before the procedure helps with these possible side effects. Most women can resume daily activities right away.
⦁ Surgery: This type of diagnosis involves a surgical process called Laparoscopy, Your doctor will make a small opening in your belly and insert a special telescope or laparoscope to look at your uterus and fallopian tubes. During this surgery, the doctor can look at your fallopian tubes to see if they are blocked. Usually, the doctor inserts a dye through the cervix into the uterus and fallopian tubes to confirm that the dye passes through the ends of the tubes. In certain cases, laparoscopy may be used to confirm a previous diagnosis of hydrosalpinx or other conditions.
Treatment of Hydrosalpinx
Research has shown that currently, the most effective way for treating hydrosalpinx is surgical correction and there are as follows;
⦁ Salpingostomy: This is a minimally invasive surgery where the laparoscope is surgically inserted into the abdomen and an incision is made to remove some enlarged or damaged part of the fallopian tube. Also, the affected tube is opened to drain the fluid through a small incision. The tube is then clipped to stop any fluid from leaking into the uterus. This surgical method can also be used to remove endometrial growth and other scar tissue or adhesion affecting fertility.
⦁ Salpingectomy: This surgical process involves the total removal of the fallopian tube few doctors shy away from this treatment because it may affect the blood supply to the ovary. Without a good blood supply, the ovarian function may be impaired and cause issues with IVF.
⦁ Sclerotherapy: This method is also invasive and with the of ultrasound. The surgeon uses the ultrasound-guided needle to draw out the fluid, By injecting a chemical called sclerosing which irritates the swallowing tube and forces it to push out the buildup fluid. This treatment enables fast recovery time, But more research needs to be done to check the reoccurrence of hydrosalpinx with this treatment method.
Hydrosalpinx and Pregnancy
when your fallopian tubes are completely blocked, an egg cannot travel through them to your womb. You will need to be treated by a fertility specialist to become pregnant. Your doctor may occasionally be able to open the tubes with surgery.
If there is too much damage to the tube(s), you will need treatment that does not involve the tubes to help you get pregnant, such as in vitro fertilization (IVF). In this procedure, your egg is joined (fertilized) with sperm in the laboratory. Then the doctor places the fertilized eggs (embryos) into your womb. Your doctor may recommend that your hydrosalpinx is removed or separated from the womb before you start IVF treatment, as the hydrosalpinx may lower your chance of pregnancy.
Your ability to get pregnant with a hydrosalpinx will vary depending on the severity of your blockage and your treatment choice. Without treatment, pregnancy is possible, but the chances of complications, like miscarriage, are higher. With treatment, the outlook is much better, especially with IVF.