One of the serious consequences of inflammation of the appendages is a disease of the fallopian tubes - hydrosalpinx. According to statistics, it is detected in 30% of women of reproductive age. Pathology interferes with the successful conception of a child. However, with adequate treatment, pregnancy is possible. In today's article, we will talk about how to recognize an ailment in a timely manner, what methods of treatment modern medicine offers.
Structure and function of fallopian tubes
To understand the mechanism of the development of the disease and its possible causes, it is necessary to delve into the anatomy. The uterine or fallopian tube is a paired organ with two gaps. Its length is 10-12 cm. One of the ends of the tube opens into the uterus, and the other ends with villi and exits near the ovary. Through these holes, the abdominal cavity communicates with the genitals.
The walls of the fallopian tube consist of three layers:external, muscular and internal. The first is represented by the peritoneum and performs a protective function. The muscular layer contributes to the emergence of contractile movements directed towards the uterine cavity. The inside of the fallopian tube is lined with ciliated epithelium. Its main function is to make wave-like movements, thanks to which the fertilized egg freely enters the uterus. Glandular cells are located between the elements of the ciliated epithelium. They are responsible for developing a special secret. This substance supports the viability of sperm, egg and embryo at the initial stages of its development.
What is tubal hydrosalpinx?
This is a gynecological disease that over time leads to impaired patency of the fallopian tubes. It is characterized by a gradual accumulation of transudate in the lumen of the canals. As a result, the pipe turns into a formation that looks like a bag. At the initial stage of development, the pathological process practically does not manifest itself. Usually, the disease is diagnosed when a woman goes to the gynecologist in search of the causes of infertility.
Doctors distinguish the following forms of hydrosalpinx:
- left hand;
- right hand;
- double-sided.
The unilateral form of the disease is characterized by the appearance of inflammation on only one tube. In this case, a woman can become pregnant on her own, but the probability of successful conception is halved. With bilateral hydrosalpinx, both tubes are blocked. It is impossible to get pregnant with such a diagnosis ifdo not consult a doctor in a timely manner. Subsequently, complete infertility may form, in which the probability of independently enduring and giving birth to a he althy child is zero.
Separately, it is necessary to consider the chronic form of pathology. It develops gradually and is not manifested by any deviations. The woman feels great. Hydrosalpinx of the fallopian tubes is found by chance, during examination by a gynecologist. Therefore, it is so important to periodically undergo a preventive examination by this doctor.
Mechanism of disease progression
Disruption of the fallopian tubes begins with inflammation, such as salpingitis or salpingoophoritis. There is a pathological proliferation of connective tissue, numerous adhesions and scars are formed. Inflammation gradually spreads to all layers of the fallopian tubes.
The villi of the ciliated epithelium die, and the muscle layer ceases to fully contract. Adhesions grow in the lumen of the tube, disrupting its patency. A secret begins to accumulate in the formed cavity. It is produced by the glands of the epithelium in response to the existing inflammation. Thus, a disease of the fallopian tubes develops - hydrosalpinx.
Main reasons
The onset of the disease is due to the closure of the middle section of the fallopian tubes. Usually such a problem is the body's response to a local inflammatory process. Infectious agents penetrate both ascending and descending pathways. In the first case, they mean organsreproductive system (cervix, uterus, vagina). In the second, we are talking about the intake of infectious agents along with the blood flow from the appendix, kidneys or bladder. Sometimes inflammation has an aseptic nature, when its development is preceded by various gynecological ailments.
Doctors identify the following causes of hydrosalpinx of the fallopian tubes:
- frequent abortions, diagnostic curettage of the uterine cavity;
- use of intrauterine device;
- hypothermia (activation of pathogenic flora against the background of weakened immunity);
- frequent change of sexual partners;
- inflammatory processes affecting the area of the appendages and ovaries (oophoritis, adnexitis);
- sexual infantilism;
- adenomyosis;
- endometritis;
- vaginal dysbacteriosis.
One-sided process (hydrosalpinx of the left fallopian tube or only the right one) often occurs due to anatomical disorders or due to pyosalpinx. In this case, the purulent contents are completely absorbed, only a serous secret remains. A bilateral pathological process affecting both fallopian tubes is formed against the background of chronic inflammation caused by various infectious agents.
Clinical picture
What are the symptoms of tubal hydrosalpinx? At the initial stage of the development of the disease, there are no characteristic signs, since inflammatory processes are not active. It is revealed, as we have already said, by chance, during an examination by a gynecologist.
As you progressailment, an expanded clinical picture appears. Increased secretion of mucus by the glands of the epithelium leads to overfilling of the tubes, as a result of which they increase in size. Because of this, the woman has a feeling of heaviness in the lower abdomen. If the pathology is bilateral in nature, such a symptom manifests itself on both sides. Periodically, it is possible to increase the temperature to subfebrile indicators. In some cases, women report increased secretion from the vagina.
When diagnosed with "obstruction of the fallopian tubes" hydrosalpinx affects the reproductive abilities of the organism. When the lumens are completely closed, the egg cannot get inside, so fertilization does not occur. This disorder is called tubal infertility. If the lumen is not completely blocked, the mucosal folds are smoothed out, and the muscle tissue atrophies. As a result of these changes, a woman has an increased risk of an ectopic pregnancy.
An unpleasant complication of hydrosalpinx is rupture of the fallopian tube. This disorder is characterized by the appearance of severe pain in the lower abdomen and tachycardia, a decrease in blood pressure. The skin gradually turns pale, distinct sweat bubbles appear on it. If these symptoms occur, you should immediately call a medical team.
Hydrosalpinx and pregnancy
Laparoscopy is recommended for women with hydrosalpinx who are planning a pregnancy. This procedure allows you to restore the patency of the pipes, but withthis often disrupts their natural function. In addition, the number of receptors for the main hormones - estradiol and progesterone - is sharply reduced. These factors can lead to an ectopic pregnancy.
If the pathological process extends to only one tube, conception is possible. However, the presence of a focus of inflammation in the pelvis is detrimental to the developing embryo. The liquid contained in it consists of lymphocytes and other toxic agents. Therefore, without surgical treatment, pregnancy is not recommended. Removal of the fallopian tubes with hydrosalpinx does not reduce a woman's sexual desire, does not affect her hormonal background or the menstrual cycle. With a bilateral form of the disease, pregnancy in a natural way is impossible. In this case, the IVF procedure is recommended for the woman.
Resection of the fallopian tubes before in vitro fertilization entails an increase in the likelihood of successful conception by about 30%. The prognosis is significantly improved if the removal operation is performed immediately, rather than trying to restore the patency of the oviducts using various laparoscopic options.
Previously, it was suggested that the removal of the fallopian tubes entails a violation of the blood supply and nervous regulation of the ovaries. The conducted studies did not confirm this information. Removal of the affected tubes before IVF does not affect the condition of the ovaries, their response to the stimulation process, the fertilization rate.
Diagnostic Methods
WhenIf you suspect hydrosalpinx of the fallopian tubes, you should immediately contact a gynecologist. Diagnosis of this disease begins with an examination of the patient. When performing bimanual palpation, the pathology is palpated in the form of an oblong, tight formation only on one side or simultaneously on both sides. This procedure may cause pain discomfort. Then they move on to instrumental diagnostic methods. Among them, the following procedures are the most informative:
- Transvaginal ultrasound. Allows you to determine the hydrosalpinx, set the localization, shape and approximate size.
- Hysterosalpingography. Helps to assess the patency of the fallopian tubes. During the diagnosis, a contrast agent is injected into the uterine cavity under pressure. After that, a series of x-rays are taken, on which the internal genital organs are clearly visible.
In medical practice, there are cases when, after such an examination, women became pregnant on their own. On the other hand, it increases the likelihood of exacerbating chronic inflammation.
A more reliable method of diagnosis is laparoscopy of hydrosalpinx of the fallopian tubes. The use of this method allows you to assess their condition and take the contents to determine the infectious agent, its sensitivity to antibiotics. Sometimes doctors refrain from laparoscopy because of its invasiveness. Such an intervention can enhance the development of the adhesive process.
Based on the results of the examination, the doctor confirms or refutes the preliminarydiagnosis and recommendations for treatment. Therapy for this pathology can be conservative or surgical. Let's consider each of the options in more detail.
Conservative treatment
Therapy should be started immediately after the doctor confirms the diagnosis of tubal hydrosalpinx. Treatment without surgery is recommended for women who no longer plan pregnancy, or with a slight severity of the pathological process. To combat inflammation, antibiotics are prescribed. The duration of the course of therapy and the dosage of medications are determined by the doctor. In this case, the specialist must take into account the sensitivity of the pathogenic flora to the drugs used and the nature of the pathogen.
Conservative treatment includes measures to stimulate immunity. For this purpose, patients are prescribed immunomodulatory drugs (Taktivin, Timalin, Imudon) and vitamin complexes. Physiotherapy procedures are widely used. They do not completely cure the disease, but have a beneficial effect on the body. Among them are:
- UHF;
- UFO;
- magnetorez;
- electrophoresis;
- endovaginal vibration massage.
If doctors have diagnosed advanced hydrosalpinx of the fallopian tubes, treatment is possible only through surgical intervention.
Surgical treatment
Surgery recommended for everyonewomen who still dream of trying on the role of a mother. In addition, surgery is indispensable in the case of a rapidly progressing adhesive process, as well as a complicated course of the disease.
How to treat tubal hydrosalpinx? Today, laparoscopy is used as a fundamental method of surgical elimination of pathology. This is the most effective and at the same time sparing method of treatment. There are several varieties of this procedure. The specific therapy option is chosen by the doctor, taking into account the he alth of the patient, the condition of the fallopian tubes.
- Tubectomy. During this operation, the doctor performs a resection of one or both tubes. It is used when there are no other options for treating the disease.
- Salpingoneostomy. The procedure involves the formation of a new hole in the fallopian tube.
- Fimbryolysis. Surgical manipulations are aimed at releasing the villi of the end section of the tube from adhesions, removing fluid.
- Salpingo-ovariolysis. During the procedure, the doctor cuts the adhesions in the lumen of the tube.
Is pregnancy possible after laparoscopy of the fallopian tubes? Hydrosalpinx is a very serious pathology, the long course of which necessarily affects the he alth of a woman. A successful operation is not a guarantee of a quick conception of a baby. If the doctor managed to save the tubes and restore their patency, the oviduct will not fully function. The cilia of the ciliated epithelium may lose their mobility, and the muscle layer often stops contracting. As a result, the normalperistalsis. Therefore, women after the operation are at risk of ectopic pregnancy. Fertilization through IVF is recommended for such patients.
Prevention measures
Hydrosalpinx of the fallopian tubes, the treatment of which is described just above, is a serious disease. However, its occurrence can be prevented if the following recommendations are followed:
- It is necessary to treat gynecological ailments in a timely manner. If you experience pain, unusual discharge or other unpleasant symptoms, you should immediately contact a gynecologist.
- It is important to follow the basic rules of personal hygiene. Shower doctors advise to take twice a day. During menstruation, you should change your hygiene products as often as possible.
- Better to avoid promiscuity and always use barrier contraceptives.
- It is necessary to adhere to a he althy lifestyle, to exclude all addictions.
Hydrosalpinx of the fallopian tubes, if left untreated, can provoke the development of serious complications. These include not only infertility. Even with the successful conception of a baby, there is a chance of miscarriage or spontaneous miscarriage.
