How is tubal hydrosalpinx treated? indications for surgery. Hydrosalpinx on the right

One of the main reasons female infertility considered pathological disorders in fallopian tubes Oh. Most often, this is the result of inflammatory phenomena in the pelvic organs, a complication of which is usually hydrosalpinx. What it is? This is a pathology characterized by the accumulation of fluid in the lumen of the fallopian tube due to a violation of its patency. In this article, we will tell you in as much detail as possible about the main causes of the development of hydrosalpinx and the methods of treatment offered today.

How do fallopian tubes function?

To understand the main reasons for the development of this pathology, it is first necessary to study the features of the work of the fallopian tubes. They are double-lumen tubes, each of which is attached to the uterus on one side, and ends with fimbriae on the other. Given the importance of reproductive function, bilateral hydrosalpinx can be very dangerous. Exactly at fallopian tubes Ah, there is a “meeting” of the egg directly with the spermatozoon, that is, fertilization. Then the zygote with a current of mucus is directed towards the uterine cavity, where it implants.

If the patency is impaired, fertilization is not possible. In this case, we are talking about infertility. If the muscular membrane of the tube is damaged, the promotion of the zygote into the uterine cavity is also impossible. If a fertilized egg remains in the tube for more than four days, the likelihood of implantation here increases. As a result, a so-called ectopic pregnancy develops.

As a rule, obstruction is a consequence of the inflammatory process. In this case, the volume increases connective tissue, adhesions and numerous scars are formed. The villi of the mucosa die, the muscular membrane loses its habitual ability to periodically contract, the fimbria stick together. If adhesions block both openings of the pipe, mucus begins to gradually accumulate in its lumen large quantities hydrosalpinx develops. Treatment of this pathology should be prescribed immediately, because the bill is literally on the clock. The fluid in the tube begins to become inflamed, the walls stretch, and the adhesive process in the pelvis increases. It's a vicious circle.

What is hydrosalpinx?

This is a disease of the fallopian tubes, characterized by a violation of their normal patency and accumulation of fluid (transudate). This pathology considered to be common. A transudate is a pale yellow fluid that is normally produced by the walls of the fallopian tube.

Usually, the disease occurs against the background of an adhesive process in the folds of the mucosa due to inflammation. These adhesions form special reservoirs where transudate can accumulate. The size of the formation varies from one to several centimeters. Depending on which side of the fallopian tube is affected, left-sided hydrosalpinx and right-sided are isolated. Sometimes doctors diagnose the bilateral nature of the pathology.

The disease can provoke an ectopic pregnancy or infertility. In addition, it reduces the chances of a successful IVF result. Experts explain this by the fact that the transudate is toxic to the fetus inside the womb and can cause its death.

The main causes of the development of pathology

Infections transmitted directly through sexual contact.
Endometriosis.
Chronic inflammation of the appendages.
Previously transferred salpingitis, adnexitis.
Adhesions in the pelvic organs due to surgical procedures.

What are the signs of hydrosalpinx?

Symptoms of the disease, regardless of the root cause of its development, appear the same in all cases. Many women may not pay due attention to them for a long time, attributing malaise to PMS or ovulation. This is the main insidiousness of the disease. Woman ignores warning signs, the cavity increases in size, the serous fluid transforms into exudate, complications arise.

For any anomalous phenomenon you should seek the help of a doctor. If pregnancy is planned, such a pathology must be taken especially carefully, because even timely treatment is not a guarantee of updating the reproductive function.

Symptoms of the disease are identified in the following manifestations:

Severe pulling pains in the lower abdomen.
Profuse watery discharge with an unpleasant odor.
Ectopic pregnancy, miscarriage.
Fever, general malaise, apathy.

It is better to immediately consult a doctor if you suspect hydrosalpinx. What is it and how to treat the pathology, the doctor will tell at the reception after a complete gynecological examination. Usually the disease is detected by transvaginal ultrasound.

Forms of pathology

Hydrosalpinx is a disease that can affect both the left fallopian tube and the right. It depends solely on which side the adhesive process. In the case of a unilateral variant, the woman retains the ability naturally get pregnant. However, this possibility is halved, since only one fallopian tube remains absolutely healthy.

With a bilateral variant of the disease, both tubes are affected. In this case, the conception of a child in a natural way is not possible.

In addition, the following forms of this disease are distinguished:

Simple hydrosalpinx (one cavity).
Follicular variant of the pathology (the cavity is divided into several parts by adhesions).
Ventilated hydrosalpinx. What it is? With this form of the disease, the “reservoir” is periodically emptied, and its contents are poured directly into the uterine cavity itself.

Is it possible to get pregnant with such a disease?

Very often you can hear that pregnancy and hydrosalpinx are two incompatible things. In fact, everything is not as sad as it seems at first glance.

After the restoration of the fallopian tubes, they are far from always able to fully function, since the villi on the mucosa stop working. There is still a chance to try on the role of a mother. It exists even if the disease entailed the complete removal of the fallopian tubes. In such situations, IVF technology is usually recommended to patients. Pregnancy, as a rule, does not occur immediately. Women need long-term treatment and constant medical supervision.

Diagnosis of the disease

The treatment of this disease can be started only after the doctor confirms the diagnosis of hydrosalpinx. Treatment is prescribed on an individual basis. We will talk more about the main methods of therapy later in this article.

Professional diagnostics consists of several stages. The disease is far from always possible to determine immediately, especially if the fallopian tubes cannot be visualized on an ultrasound machine. This is usually due to a large number adhesions, an abundance of fluid behind the uterus. In this case, the doctor can suggest what should be done to eliminate the existing interference and how to properly prepare for the future ultrasound.

Diagnostic measures include:

Taking an anamnesis, studying the symptoms of the disease and complaints of the patient.
Classic gynecological examination.
Ultrasound of the pelvic organs.
Taking material for laboratory research.
Analysis for the detection of fungi and pathogenic microflora.
Laparoscopy.

As a rule, the disease can be diagnosed during an ultrasound examination. Further diagnostic measures necessary to confirm the disease. In the presence of pathogenic bacteria, appropriate therapy is prescribed. If the doctor determines the adhesive process on ultrasound, surgical intervention may be required. This pathology very often accompanies hydrosalpinx. Treatment without surgery in this case is not possible.

Conservative therapy

A conservative treatment option is aimed at stopping the inflammatory process through physiotherapy and taking antibiotics. The selection of drugs is carried out on an individual basis. This option is appropriate only for the primary development of the disease or inflammation of the appendages. In all other cases drug therapy plays an extremely stabilizing role. Almost always, after the discovery of the disease, a woman is prepared for the fact that sooner or later the hydrosalpinx will need to be surgically removed.

Surgery

Surgical treatment involves laparoscopic surgery. Reconstructive intervention is aimed at emptying the hydrosalpinx, followed by the obligatory expansion of the fallopian tube, as a result of which its patency increases. Adult women who have already given birth are usually recommended a complete resection of the affected area of the organ.

Conceiving a child after laparoscopy is impossible in a natural way, the help of reproductive technologies (IVF) is required. Patients with this diagnosis automatically fall into the risk group for the onset of the so-called ectopic pregnancy.

AT recent times an operation called salpingostomy is increasingly recommended for women diagnosed with hydrosalpinx. During this procedure, the surgeon creates a small hole in the fallopian tube for the outflow of fluid, and also dissects the existing adhesions. The main disadvantage of such an operation is reappearance soldering after a while. That is why surgical intervention of this kind is recommended for women after 35 years.

How to treat hydrosalpinx: folk remedies

Therapy folk remedies is not effective, but many women resort to it as an adjunct treatment. Before doing this, it is recommended to consult a doctor. Below we list the most popular recipes.

Two teaspoons of Adam's root must be poured with a glass of boiling water, insisted for about three hours. The resulting infusion should be taken three times a day for a tablespoon.
You will need to take three tablespoons of one-sided ramishia, pour 0.5 liters of boiling water. The decoction is recommended to infuse in a thermos for one night. The next day, you can take the resulting medicine 2/3 cup four times a day after meals.

Note folk therapy cannot be used as the only option for a diagnosis such as hydrosalpinx. Treatment without surgery is often ineffective. Moreover, therapy with folk remedies should be started with the permission of the gynecologist. Otherwise, it will not succeed.

Consequences of the disease

What complications can hydrosalpinx provoke? The causes of the development of this disease are hidden in inflammatory processes affecting the pelvic organs. Absence timely treatment may lead to the development of serious complications. First of all, they include infertility and ectopic pregnancy. In addition, chronic hydrosalpinx complicates the success of the IVF procedure.

Preventive actions

Because hydrosalpinx is dangerous, this disease affects directly the reproductive function of the body. That is why every woman should know how to prevent the development of this pathology.

First of all, doctors recommend timely and high-quality treatment of all diseases of an infectious and inflammatory nature. It is equally important to observe the rules of personal hygiene (take a daily shower, change underwear). It is better to exclude casual sex, and during intimacy to use barrier means contraception. It is necessary to regularly visit a gynecologist and strictly follow all his instructions. Only if all of the above recommendations are observed, it is possible to preserve the main natural function of every woman - the ability to bear children.

You should not be afraid of a disease such as hydrosalpinx. Reviews of many women who had to deal with this pathology prove the need for timely seeking help from a doctor. If it succeeds on early stage diagnose the disease, the likelihood of serious complications is low.

In addition to antibiotic therapy, much attention is paid to strengthening immune protection. For this, women are prescribed immunomodulators - for example, Taktivin, echinacea tincture, Immunal, Imudon, etc., as well as vitamins and physiotherapy. The above treatment will not be able to completely rid the woman of the disease, however, it will significantly improve her well-being and stop the pathological process.

Medicines to slow down the process of hydrosalpinx formation

Antibiotics for hydrosalpinx:

Ampicillin - diluted with novocaine or saline, administered in the form of intramuscular injections of 0.5 g 4 times a day;
Apmioks - take orally two capsules 4 times a day;
Ecocephron - taken orally 1-2 capsules 3-4 times a day;
Cefotaxime - administered intramuscularly, 1000 mg every eight hours;
Metronidazole - take 1 tablet up to 4 times a day;
Furazolidone - take 2 tablets 4 times a day against the background of the main antibiotic therapy.

To prevent dysbacteriosis, antibiotic therapy is carried out against the background of taking antifungal agents and probiotics (Ketoconazole, Linex, etc.).

Non-steroidal anti-inflammatory drugs:

Paracetamol - take 500 mg up to 4 times a day;
Butadion - take 100 mg 2-3 times a day, between meals;
Ibuprofen - take 0.4-0.8 g three times a day.

For potentiation medicinal action and to strengthen the immune system, the treatment is supplemented with the intake of vitamin preparations.

Vitamins, immunomodulators and complex vitamin preparations:

Ascorbic acid - take 0.5 g per day, daily;
Tocopherol - take 0.1 g daily for a couple of weeks;
Cocarboxylase - administered in the form of intramuscular injections of 1-2 ampoules daily;
Immunofan - administered intramuscularly, one ampoule per day, for three weeks.

Longidase with hydrosalpinx is prescribed because of the ability of the drug to effectively eliminate adhesions in the small pelvis. In addition, Longidaza significantly increases the bioavailability of other medicines. The tool can be used in two ways - in the form of injections and in the form of suppositories. Injections are carried out intramuscularly, once every three days, at a dosage of 3 thousand IU. The general course can be from five to fifteen injections. If the doctor prescribes suppositories, then they are administered rectally, one suppository every other day. The duration of therapy should be determined individually. The drug is well accepted by the body. Side effects are rare: slight redness and swelling at the injection site. Longidase is especially often combined with antibiotics. For example, Longidaza and Azithromycin complement each other with hydrosalpinx, enhancing the effect of treatment: as a result, adhesions are successfully resolved, the inflammatory reaction is extinguished.
Ceftriaxone helps with hydrosalpinx purulent complications, abscess, etc. The drug is administered intramuscularly, in a certain individual dosage. Do not use Ceftriaxone in the presence of hypersensitivity to cephalosporins and antibiotics penicillin series. side effects nausea, the development of thrush appear (as a result of antibiotic therapy in general).
Cifran for hydrosalpinx is prescribed, given the ability of the drug to successfully deal with gynecological infectious diseases. Cifran is most often used orally at a dosage of 500 mg twice a day, regardless of the meal. The duration of the treatment course is about one week. Adverse symptoms are usually mild and are manifested by nausea, diarrhea, impaired appetite, and sometimes allergies.
Candles for hydrosalpinx are prescribed to almost all patients, the difference is only in the mechanism of action of such forms of drugs. For example, suppositories can have an anti-inflammatory focus (Diclofenac, Betadine), analgesic and antispasmodic effects (Indomethacin, Papaverine), a restorative effect (Methyluracil, Dexpanthenol, Longidase), and have an immunomodulatory effect (Pyrogenal, suppositories with sea buckthorn). Such drugs can only be prescribed by a doctor. Their incorrect use can lead to a number of complications: addiction, imbalance of intestinal and vaginal microflora, decreased immunity, burning sensation and pain in the genital tract.
Ichthyol candles with hydrosalpinx, apply 1-2 times a day for 10 days (unless the doctor has prescribed another treatment regimen). Such a remedy has practically no contraindications (with the exception of allergies) and has been successfully used for many years to treat salpingitis, endometritis, erosion, colpitis and other gynecological problems. According to the antiseptic effect, ichthyol is equated to Vishnevsky's ointment.
Recently, many sites have strongly recommended the use of so-called " chinese tampons". Such funds supposedly have a special therapeutic impregnation, which affects the pathological focus directly at the site of application. It should immediately be noted that similar means are not officially recognized in our country, so one should not rush to use them. Quite a few cases are already known when Chinese hydrosalpinx tampons did not heal, but caused a lot of other problems - irritation of the mucous membrane, bacterial imbalance, colpitis, etc. It would be wiser to make plans for self-treatment and consult with a competent doctor.
Gynecological garlic tampons for hydrosalpinx are made from crushed garlic cloves and warm water(water with garlic is filtered through cheesecloth). The resulting water is moistened with homemade gauze swab and injected into the vagina for no more than two hours. It is believed that this time is sufficient for active substances contained in garlic, had their therapeutic effect. This method has its fans and those who categorically reject it. Really, this remedy can cause severe irritation of the mucous membrane, up to a burn. Therefore, if you decide to use it, then you should definitely discuss such treatment with your doctor first.
Contraceptives - for example, Regulon with hydrosalpinx does not carry almost any therapeutic target load. Such drugs are used both for contraception and for the regulation monthly cycle getting rid of endometriosis. These medications do not affect the fact of hydrosalpinx in any way.
Sodium thiosulfate with hydrosalpinx can be used for suppuration of the pathological focus - in this case, the solution has a pronounced antitoxic effect. Inside, 2-3 g of the drug is prescribed in the form of a 10% solution (mixed with saline). Perhaps intravenous administration (as prescribed by the doctor).
Vilprafen with hydrosalpinx is prescribed in the form antibacterial treatment- especially if the patient is contraindicated for certain antibiotic therapy (for example, if she is allergic to penicillins). Vilprafen is taken 2-4 tablets per day (for 2-3 doses). As a rule, the course of therapy does not exceed ten days.
Biologically active additive Ginekol with hydrosalpinx promotes inhibition of the inflammatory process, potentiates regeneration. The remedy is taken for three months, two tablets per day, after consulting with the doctor in advance. Gynecol does not count drug, therefore, they take it only against the background of the general prescribed treatment.
Terzhinan with hydrosalpinx plays a role powerful antiseptic and antibacterial agent. Tablets are administered intravaginally, one piece 1-2 times a day. Treatment continues up to 10-20 days in a row. Terzhinan cannot be used simultaneously with aspirin - these drugs do not combine and can lead to complications.
Cathegel with hydrosalpinx is used topically due to the content in the preparation of chlorhexidine, which has a strong bactericidal activity. This drug is not intended for self-administration. It is used only by a doctor or specially trained medical staff, according to a predetermined treatment regimen.

Physiotherapy treatment

It is possible to use electrophoresis with iodide, magnesium and calcium salts, with enzyme preparations(Lidaza, Wobenzym, Trypsin). The procedure is carried out every day on the lower segment of the abdomen. The therapeutic course may include 10-15 sessions.

Ultraphonophoresis is used on the pelvic area - in this case, the use of Lidase, Terrilitin, Hyaluronidase is appropriate, oil solution tocopherol (2-10%), Ichthyol. Sometimes referred to as medicinal substance ointments, which include Indomethacin, Troxevasin, Heparin. The course of ultraphonophoresis includes 15 sessions.

Vaginal irrigation is carried out by the method of introducing hydrogen sulfide, nitrogen, siliceous, radon water. The water is preheated to body temperature. Irrigation is repeated once every two days, and the entire course of therapy includes 12 sessions.

Applicator application of mud on the lower segment of the abdomen is carried out every other day, for about half an hour. The therapeutic course is from 10 to 15 sessions.

Alternative treatment

In addition to basic therapy prescribed by a doctor, you can apply and folk treatment. This will help the body fight the disease with a vengeance, enhancing the effect of other medicines.

Stop the growth of capsule formation will help potato juice. It is drunk on an empty stomach 30 minutes before each main meal for a couple of months.

Take 1 tsp. flax seed, 200 ml of water. Seeds are poured with water, brought to a boil over low heat and removed from heat for infusion. Take the resulting and filtered decoction of 100 ml every 2-3 hours.

Potato juice and decoction of flax from hydrosalpinx are considered the "number one" means. They can be combined together: in this case, the treatment will be even more effective.

Also, many drink medicine based on St. John's wort. Prepare it like this: first steam 1 tbsp. l. raw materials in 200 ml of boiling water, insist 1 hour. Then put on fire, bring to a boil and hold on low heat for another quarter of an hour. After that, the medicine is cooled, filtered and drunk on an empty stomach three times a day for 5 tbsp. l.

Some sources claim positive effect hirudotherapy. However, most experts are sure that leeches will not completely relieve hydrosalpinx, but will only give a temporary effect. The functionality of the tubes can only be partially restored by surgical intervention. However, to improve the regeneration process, hirudotherapy is quite acceptable: the procedures are carried out in a course, in a special clinic under the supervision of a doctor.

Vishnevsky's ointment with hydrosalpinx eliminates the adhesive process - the main cause of the onset of the disease. One ointment for successful treatment small: it is also necessary to prepare a medicinal collection from the same quantities of eucalyptus leaves, chamomile flowers, calendula, and also oak bark. Pour boiling water over 1 tbsp. l. collection, insist for half an hour. The infusion is filtered and douching is done (the liquid should be warm) at night, and immediately after the procedure, a swab treated with Vishnevsky ointment should be inserted into the vagina. A tampon is made by hand (the usual purchased one will not work) from a sterile bandage and thread. The procedures are repeated daily for three weeks.

Before embarking on any self-treatment, you must first consult a medical specialist.

Herbal treatment

Knotweed herb is considered to be a good restorative agent in gynecology. The medicine from this plant is prepared according to this method. Brewed in 1000 ml of boiling water 5 tbsp. l. knotweed, cover with a lid and a warm scarf and incubate for about 40 minutes. Then the infusion is filtered and drunk throughout the day - for example, instead of tea. Such treatment lasts at least a month, after which a break of 10-14 days should be taken.
Anise seeds in the amount of 100 g are mixed with 1 liter of honey, kept for three days at room temperature. Take the drug for 1 tsp. three times a day before meals.
The sage plant is widely known as an excellent anti-inflammatory and regenerating agent. To make a cure for hydrosalpinx, you need to take 1 tsp. sage, brew in a glass of boiling water, leave for half an hour in a closed container. The resulting amount of infusion should be drunk during the day (for example, three times). Similar treatment may continue until the condition improves.
upland uterus in hydrosalpinx it is used as often as in others gynecological problems. To make an infusion, take 10 g of the plant, brew in boiling water (200 ml) and infuse for 20 minutes. Use 1 tbsp. l. infusion 5 times a day. You can also buy ready-made alcohol tincture boron uterus: drink it with water, 30 drops three times a day between meals. The course of treatment using a boron uterus should last three months.

Homeopathy

Program homeopathic treatment selected during an individual consultation. During the first few days homeopathic preparations can cause a slight deterioration in the form of pain in the head, nausea, general weakness. Within a few days, the state of health is normalized.

The following homeopathic remedies are most widely used:

Lachesis - is prescribed for inflammatory processes in the genital area;
Pulsatilla - strengthens the immune system, stabilizes reproductive function;
Gormel - restores the functioning of the internal genital organs;
Gynecocheel - promotes the restoration of damaged tissues;
Apis - is used to treat inflammatory processes affecting the pelvic organs.

Homeopathic prescriptions must be combined with the main treatment, as well as with the intake of folic acid, B vitamins, additional sources of magnesium, potassium, zinc.

Surgery

The help of a surgeon is usually recommended for all women diagnosed with hydrosalpinx who plan to become pregnant in the future. To date, the main method of surgical access for this disease is considered laparoscopy. This procedure can take several forms. What exactly to apply in relation to the patient, the doctor decides.

Tubectomy is a resection of the tube, or two tubes. it extreme case when no other treatment is being considered.
Salpingostomy involves creating a hole in the tubes of the uterus to connect them with the abdominal cavity.
Fimbryolysis aims to free the villi, clean out adhesions, and get rid of fluid.
Salpingo-ovariolysis is the excision of adhesions in the tubal lumen.

Laparoscopy for hydrosalpinx is always the preferred method. Such an operation is relatively fast, as is the recovery after it. At the same time, the structure of the organ suffers minimally, which significantly increases the woman's chances of further pregnancy.

Treatment of hydrosalpinx with a laser is referred to as physiotherapeutic procedures: such therapy is appropriate if the operation is impossible for some reason. The affected area is affected by laser light radiation - its power is 5-100 watts. Thanks to the procedure, metabolic reactions are optimized, adhesions are softened, and the patient's chances of pregnancy increase.

Hydrosalpinx - gynecological disease, which for a long time may go unnoticed. It is better to start treatment as early as possible, since hydrosalpinx often leads to infertility.

And now let's dwell on this in more detail.

What is "hydrosalpinx"?

Hydrosalpinx is a disease that occurs as a complication after. It is considered quite dangerous and often leads to infertility. Pathology is the accumulation of fluid in the cavity of the fallopian tubes. In many cases, the problem is asymptomatic and is detected when a woman undergoes an examination due to infertility that has already taken place. Diagnostics is carried out by instrumental methods, and surgical intervention is usually necessary for treatment.

Serous effusion accumulates in the fallopian tubes and disrupts their patency. Every year the problem occurs more often and becomes the cause of miscarriage, non-engraftment of the embryo and ectopic cases of attachment of a fertilized egg.

Pathology may appear in one of the fallopian tubes or have bilateral localization. The contents of the cavity are serous fluid or pus.

Depending on quantity pathological formations, distinguish between simple and multichamber hydrosalpinx. The second type is diagnosed in the presence of several cavities. Their sizes can reach several centimeters. The valve form of the disease is called cases when the cavity bursts and the contents come out through the uterus and vagina. The woman feels sharp pain and notices watery discharge. When the fluid accumulates in a small amount, the discomfort may not be severe.

The disease has an acute and chronic course. In the first case, the symptoms are pronounced, in the second - they are erased and non-specific.

What does hydrosalpinx look like with a photo

What a hydosalpinx looks like is shown in the picture.

The fallopian tube may have one inflated area or several, depending on the number of pathological cavities.

The first signs of hydrosalpinx

Pain is not the first sign of a disease. On the contrary, they join when the pathology progresses, accompanied by inflammation or activation of the bacterial flora. Pain may occur when acute course hydrosalpinx, however, this is preceded by earlier symptoms:

worsening general well-being;
temperature rise to subfebrile values;
pulling sensations, which many patients attribute to the past.

If the cavity with the liquid bursts, then the woman has a watery discharge. At small size hydrosalpinx formations, many patients do not attach importance to such a symptom, which leads to an untimely visit to the doctor.

At chronic course the first signs of the disease are generally absent. Pathology is detected by chance during an ultrasound examination.

Symptoms of hydrosalpinx

Hydosalpinx appears as a complication after inflammation of the fallopian tubes or ovaries. The cavities themselves with liquid may not cause discomfort, and the inflammatory process becomes noticeable by the following symptoms:

Temperature rise, headache, weakness, nausea, which appear as a result of intoxication of the body. In a chronic course, the temperature rises slightly, in an acute one, it reaches a value of 39 degrees.
Failure of the menstrual cycle.
Watery discharge from the vagina.
Aching pains on the side of the lesion.

When the hydrosalpinx ruptures, it appears sharp pain, dizziness, deterioration in general well-being, cramping spasms, tachycardia.

Diagnostics

For the diagnosis of the disease are used:

examination on a chair, during which smears are taken from the genital tract for further analysis;
sonography;
diagnostic laparoscopy (thickened fallopian tubes with watery contents are displayed on the monitor);
palpation, in which rounded formations are palpated (the patient may feel pain when pressed);
Ultrasound (superficial or transvaginal);

When examining a patient, the doctor evaluates the size of the ovaries and uterus. The study of a smear for microflora makes it possible to identify the presence and strain of an infectious agent. As confirming methods, a woman is given:

Hysterosalpingography is an x-ray with a contrast agent that is injected into the fallopian tubes.
Magnetic resonance imaging - shows the image of the pathological area in the section, where you can see the location of adhesions and the size of the capsule with the liquid.

Causes and prevention of hydrosalpinx

Hydrosalpinx is a complication after. It, in turn, can be called the following reasons:

Hypothermia. Promotes the activation of pathogenic flora, the weakening of protective functions and the inflammatory process.
Abortions or miscarriages in the past. The role is played by mechanical damage to the appendages, as well as the introduction of infection during the operation.
- Inflammation of the uterus.
Incorrectly installed uterine spiral.
- reduces the patency of the fallopian tubes.
Gynecological operations in history - scars or adhesions may remain on the uterus and ovaries, which violates the protective properties of organs and makes them more susceptible to negative factors.
Protection not barrier methods contraception - an increased likelihood of infection and chronic inflammatory processes;
infections urinary system- inflammation and the pathogen are easily transmitted to the genitals.
Uterine fibroids - mechanically squeeze the appendages, which provokes the formation of adhesions, inflammation and hydrosalpinx;
Dysbacteriosis of the vagina and even intestines - leads to a decrease defensive forces, activation of pathogenic flora, which spreads through the genital tract.

FROM right side hydrosalpinx may occur as a complication. Important role systemic endocrine diseases, as well as the psycho-emotional state, play in the formation of hydrosalpinx. Constant stress and frequent hypothermia cause many diseases in the field of gynecology.

The mechanism of the development of the disease is as follows:

As a result of the action of a provoking factor, a woman begins a disease of the genital organs in the small pelvis.
During it occur structural changes in tissues - the connective fiber grows, partitions, pseudocysts and adhesions appear.
The lumen of the tube narrows, in some areas complete obstruction is possible.
In the pathological area, microcirculation and lymph circulation are disturbed, which leads to the accumulation of fluid - transudate. It is made up of blood plasma extracellular fluid and secretion of the mucous membrane of the tubes.
The amount of pathological fluid increases, which is why the walls of the fallopian tube are stretched. Over time, this leads to their deformation and thinning of the walls.
The fluid may periodically come out of the formed bubble, but later the disease recurs, as adhesions remain on the pipes.

Thus, the main causes of hydrosalpinx are local infectious and inflammatory processes, as well as mechanical damage after operations.

Treatment of hydrosalpinx

Conservative treatment of hydrosalpinx is ineffective. Medications are not able to restore the patency of the fallopian tubes and eliminate adhesions. Due to the fact that structural disorders of the organ persist, the disease is prone to recurrence. Another reason in favor of surgical intervention is the big problems with carrying a pregnancy due to the presence of pathological cavities with fluid.

To date, the tactics of treating hydrosalpinx consists of two stages. The first is to stop the very cause of the disease - stopping the inflammatory process and the active growth of pathogenic microflora. For this, anti-inflammatory and antibacterial drugs. This also includes vitamin remedies, as well as physiotherapeutic techniques - electrophoresis, laser exposure.

After the pathological process is stopped, surgical treatment is prescribed. Preference is given to laparoscopic surgery, as it is modern, minimally invasive and effective method. Given the individual course of hydrosalpinx and its localization, fimbriolysis, salpingostomy and other types of interventions can be performed.

After the operation, the patient is waiting rehabilitation period. Mud therapy, electrical stimulation of the fallopian tubes are often prescribed here.

Complications and consequences

Unfortunately, even the successful removal of hydrosalpinx is not a guarantee of pregnancy. In addition to structural damage, in the fallopian tubes after the disease, there is a violation of peristalsis.

The sooner hydrosalpinx treatment is started, the higher the chances of a woman to save reproductive health. Hydrosalpinx is not a sentence and there are quite a lot of cases of successful childbirth after recovery.

The main complication is the rupture of the capsule with liquid. It may contain protein, white blood cells, and pus. When a transudate enters the abdominal cavity, peritonitis occurs, which is dangerous to health. In addition, the accumulation of a large amount of fluid increases the pressure on the fallopian tube, the walls of which are thinned. If the fallopian tube ruptures, the woman's condition will be critical and will require urgent hospitalization.

Hydosalpinx complications are also:

change in the position of the uterus;
development, since a fertilized egg cannot pass through the fallopian tube;
abscess due to accumulation of pus;
violation of the microflora of the vagina and intestines;
failure of the menstrual cycle.

Forecast

According to statistics, left-sided hydrosalpinx is more common. The disease is dangerous by rupture of the fallopian tubes, the onset of an inflammatory or infectious process as well as infertility.

With unilateral hydrosalpinx, the chance of becoming pregnant remains, since the adhesive process affects only one fallopian tube. Permeability in it can only be restored surgical method, however, even this does not guarantee normal functioning and peristalsis. With bilateral pathology, doctors consider the chances of getting pregnant almost zero.

When the fallopian tube ruptures, the patient falls into a critical condition and requires urgent hospitalization. The release of transudate into the abdominal cavity will lead to peritonitis - an inflammatory process with the development of edema, intoxication and circulatory disorders. The ingress of pus and serous contents from the sac into the blood is dangerous for a woman's life and can be fatal.

- hydrosalpinx. According to statistics, it is detected in 30% of women reproductive age. Pathology interferes with the successful conception of a child. However, when adequate treatment pregnancy is possible. In today's article, we will talk about how to recognize the disease in a timely manner, what methods of its treatment modern medicine offers.

The structure and functions of the 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 paired organ with two openings. 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 abdomen communicates with the genitals.

The walls of the fallopian tube consist of three layers: outer, muscular and inner. The first is represented by the peritoneum and performs 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. Between the elements of the ciliated epithelium are located They are responsible for the development of a special secret. This substance maintains the viability of sperm, egg and embryo at the initial stages of its development.

What is tubal hydrosalpinx?

This is a gynecological disease that eventually leads to a violation. 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. On the initial stage development of the pathological process practically does not manifest itself. Usually, the disease is diagnosed when a woman turns to a gynecologist in search of the causes of infertility.

Doctors distinguish the following forms of hydrosalpinx:

left-sided;
right hand;
bilateral.

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 if you do not consult a doctor in a timely manner. Subsequently, it may form complete infertility, at which the probability of self-bearing and giving birth healthy child equals zero.

Separately, it is necessary to consider chronic form 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.

The mechanism of the development of the disease

Violation of the fallopian tubes begins against the background of inflammation, for example, with salpingitis or salpingoophoritis. going on pathological growth 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 muscle layer ceases to fully shrink. 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 downward path. In the first case, they mean the organs of the reproductive 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 distinguish the following causes of hydrosalpinx of the fallopian tubes:

frequent abortions, diagnostic curettage uterine cavity;
use of an intrauterine device;
hypothermia (activation of pathogenic flora occurs against the background of weakened immunity);
frequent change of sexual partners;
inflammatory processes affecting the area of the appendages and ovaries (oophoritis, adnexitis);
adenomyosis;
endometritis;
vaginal dysbiosis.

A unilateral 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 characteristics are absent, since inflammatory processes do not show activity. It is revealed, as we have already said, by chance, during an examination by a gynecologist.

As the disease progresses, an extended clinical picture. 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 note increased secretion from the vagina.

With the diagnosis of "obstruction of the fallopian tubes" hydrosalpinx is reflected in the reproductive abilities of the organism. When the lumens are completely closed, the egg cannot get inside, so fertilization does not occur. Such a violation is called If the lumen is not completely blocked, the mucosal folds are smoothed out, and muscle tissues atrophy. As a result of these changes, a woman has an increased risk of ectopic pregnancy.

An unpleasant complication of hydrosalpinx is the rupture of the fallopian tube. This disorder is characterized by severe pain in the lower abdomen and tachycardia, lowering blood pressure. The skin gradually turns pale, distinct sweat bubbles appear on it. If these symptoms occur, you should immediately call a team of medical workers.

Hydrosalpinx and pregnancy

Laparoscopy is recommended for women with hydrosalpinx planning a pregnancy. This procedure allows you to restore the patency of the pipes, but their natural function is often disrupted. 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 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.

Fallopian tube resection before in vitro fertilization entails an increase in the probability of successful conception by about 30%. The prognosis is significantly improved if an immediate removal operation is performed, 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 ovaries. The conducted studies did not confirm this information. Removal of the affected tubes before IVF does not affect the condition of the ovaries, they feedback on the stimulation process, the fertilization rate.

Diagnostic methods

If 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 most informative are the following procedures:

Transvaginal ultrasound. Allows you to determine the hydrosalpinx, to establish 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 radiographic images are taken, on which the internal genital organs are clearly visible.

AT 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 exacerbation of chronic inflammation.

A more reliable diagnostic method 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 preliminary diagnosis, gives 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 hydrosalpinx of the fallopian tubes. Non-surgical treatment is recommended for women who are no longer planning a pregnancy, or for mild 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 allow to completely cure the disease, but they provide beneficial effect on the body. Among them are:

UHF;
UFO;
magnetorez;
electrophoresis;
endovaginal vibromassage.

If doctors have diagnosed a running hydrosalpinx of the fallopian tubes, treatment is possible only through surgical intervention.

Surgical treatment

How to treat hydrosalpinx of the fallopian tubes? 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 variations of this procedure. The specific treatment option is chosen by the doctor, taking into account the health of the patient, the condition of the fallopian tubes.

Tubectomy. During this operation, the doctor performs a resection of one or both tubes. They resort to her help when there are no other options for treating the disease.
Salpingoneostomy. The procedure involves the formation of a new hole in the fallopian tube.
Fimbriolisis. Surgical manipulations are aimed at releasing the villi of the end section of the pipe from adhesions, removing fluid.
Salpingo-ovariolysis. During the procedure, the doctor dissects the adhesions in the lumen of the tube.

Is pregnancy possible after laparoscopy of the fallopian tubes? Hydrosalpinx is a very serious pathology, long course which will definitely affect a woman's health. 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, normal peristalsis is disturbed. Therefore, women after the operation are at risk of ectopic pregnancy. Such patients are recommended to be fertilized through IVF.

Preventive actions

Hydrosalpinx of the fallopian tubes, the treatment of which is described just above, is serious illness. However, its occurrence can be prevented if the following recommendations are observed:

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, hygiene products should be changed as often as possible.
It is better to give up promiscuity and always use barrier contraceptives.
must be adhered to healthy lifestyle life, eliminate all bad habits.

Hydrosalpinx of the fallopian tubes, if left untreated, can provoke the development of serious complications. These include not only infertility. Even with successful conception baby there is a possibility of miscarriage or spontaneous miscarriage.

Among the diseases that prevent normal pregnancy, there is also a hydrosalpinx, located on the right or left. Unfortunately, this is a fairly common disease, and it affects the genitals of a woman. Its main manifestation is the accumulation of transparent or yellowish pipes. AT normal condition such a liquid is also produced by the woman's body, but it is promptly excreted through the walls of the pipes.

Why does it occur?

The main cause of this disease, doctors unanimously call inflammatory processes, in particular salpingitis. They contribute to the death of the villi, functional disorders muscle part, as well as the proliferation of connective tissue, which in turn leads to the formation of adhesions, scarring and obstruction of the tubes. Transudate (fluid) cannot be normally excreted, and therefore pours into the uterine cavity. The greatest threat left-sided or right-sided hydrosalpinx is for women planning a child (after all, the desired child is incredibly difficult to conceive) and already pregnant, since the disease negatively affects the development of the fetus and practically excludes natural childbirth.

Varieties

According to the activity and duration of the inflammatory process, two forms of the course of the disease are distinguished:

Acute (characterized elevated temperature, tachycardia, weakness).
Chronic. It usually does not have well-defined symptoms, because the fluid is collected over a long period.

Depending on the location, it is customary to distinguish between hydrosalpinx on the right and on the left. The state allows you to set simple form(when there is one cavity) and follicular (when the lumen is divided into several cavities). As a rule, when diagnosing, doctors indicate what size the hydrosalpinx has on the right (left).

Symptoms

As mentioned above, the disease may not manifest itself in any way at all, or it may give itself out with symptoms such as:

elevated temperature (from 37 ° C to 39 ° C);
weakness;
pain in the pelvic and groin areas;
cardiopalmus;
blush;
water discharge (but only with the so-called "valve" form).

Diagnostics

Only an experienced doctor can immediately detect hydrosalpinx. The diagnosis can be finally established after a number of studies.

So, first of all, a standard is carried out during which education can be suspected. The patient then proceeds to ultrasound procedure. Modern devices make it possible to detect the disease quickly enough. Hydrosalpinx on the right or left can be diagnosed using hysterosalpingography (that is, x-rays) or laparoscopy (a procedure that involves inserting special instruments into the uterus for examination).

Treatment

by the most effective way to overcome the hydrosalpinx on the right or on the left is surgery. In this case, it is called laparoscopy. In general, this procedure is tolerated by patients quite easily. You can do without surgery, but only when the disease is not running. In this case, all efforts should be directed to overcoming the inflammatory process (in this regard, antibiotic therapy and physiotherapy are prescribed), as well as to improving the work immune system(for this purpose, the patient also undergoes vitamin therapy and phytotherapy).