Introduction
The term hydrosalpinx refers to the fluid block in the fallopian tubes. It can be due to an untreated infection, which damages the fallopian tube and causes a hydrosalpinx. Hydrosalpinx is typically caused by conditions like endometriosis or a previous surgery or pelvic or sexually transmitted infections. The fluid block in the fallopian tube can have an impact on fertility.
What Does Hydrosalpinx Mean?
The fallopian tubes are hollow, tubular structures that are attached to the uterus (womb) on the right and left sides. The fallopian tube has an important role to play during the ovulation process. An egg that is released from the ovary during the ovulation process is picked up by the fallopian tube. If the sperm from the vagina reaches the fallopian tube through the uterus and fertilizes the egg, the embryo travels through the fallopian tube to reach the uterus and starts developing.
Damage to the fallopian tube can cause it to become filled with serous or clear fluid. Hydrosalpinx refers to a condition in which the fallopian tubes are swollen, blocked, and filled with fluid. As the fallopian tube is damaged and blocked, a normal pregnancy may not occur, and the embryo may develop in the tube, resulting in an ectopic pregnancy. The blocked tube becomes distended and appears sausage-shaped. Hydrosalpinx often affects both the fallopian tubes and may affect a large portion of the tube.
What Happens in a Hydrosalpinx?
Hydrosalpinx is usually caused by an untreated infection. Bacteria damages the fallopian tube and causes inflammation. The inflammation usually occurs at the distal (end) portion of the fallopian tube near the ovaries or the fimbriae (finger-like extensions that move an egg from the ovary into the fallopian tubes). The tubal fluid is usually discharged into the peritoneal cavity (a space in the abdomen in which the liver, intestines, and stomach are present) through the fimbriated end, from where it gets cleared. The fimbriae may fuse and seal the fallopian tubes to promote healing. As a result, fluid gets trapped inside the tubes, causing inflammation. Therefore, the blocked fallopian tube cannot participate in the reproductive process.
What Causes a Hydrosalpinx?
Hydrosalpinx can be due to the following causes:
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Pelvic inflammatory disease (infection in the uterus, ovaries, fallopian tubes, and the inside of the pelvis) due to untreated sexually transmitted infections caused by chlamydia or gonorrhea.
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Endometriosis (a condition in which the cells that are normally present inside of the uterus grow outside the uterus).
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Adhesion formation due to the scar tissue after a fallopian tube surgery.
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Tumors involving the ovaries, fallopian tubes, or other surrounding organs.
What Are the Symptoms Associated With a Hydrosalpinx?
Symptoms of a hydrosalpinx can vary by person. Some women may remain asymptomatic, while some may present with the following symptoms:
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Recurring pelvic pain.
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A sticky and discolored vaginal discharge.
An ectopic pregnancy may be the first sign of hydrosalpinx in some cases.
What Are the Complications Associated With a Hydrosalpinx?
An untreated hydrosalpinx causes difficulties in becoming pregnant and can increase the risk of miscarriage and pregnancy complications. In addition, a hydrosalpinx can cause the following complications:
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An Ectopic Pregnancy - Hydrosalpinx increases the risk of an ectopic pregnancy, a life-threatening complication. The block in the fallopian tube prevents the embryo from reaching the uterus and may get implanted in the fallopian tubes, resulting in an ectopic pregnancy.
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Decreases the Chances of Pregnancy - Hydrosalpinx decreases the chances of becoming pregnant. Women with hydrosalpinx opt for IVF (in vitro fertilization) methods. In IVF, eggs are collected from the mother and are fertilized outside the body using the sperm from the partner. The fertilized embryo is then implanted into the uterus, where it continues to develop. Hence, pregnancy is possible without the function of the fallopian tubes.
If only one fallopian tube is blocked, pregnancy is possible as the egg is not released from the same ovary. The eggs are released alternately from the ovaries, and sometimes eggs are released from both ovaries at the same time.
How Is a Hydrosalpinx Diagnosed?
A healthcare professional uses the following methods to diagnose a hydrosalpinx and to check if one or both tubes are blocked.
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Hysterosalpingogram (HSG) (X-Ray) - A contrast dye is injected into the uterus through the cervix, and an X-ray is taken to check if there is a block. The injected contrast dye flows out of the tube into the peritoneal cavity if the fallopian tubes are open. If the fallopian tubes are blocked, the contrast medium will be trapped and is not detected in the peritoneal cavity, confirming the presence of hydrosalpinx.
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Ultrasound Scan - An ultrasound examination helps in diagnosing the presence of hydrosalpinx. If the fallopian tube appears enlarged, it indicates the presence of hydrosalpinx.
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Laparoscopy - A laparoscopy is a surgical technique that is minimally invasive and is performed to examine the uterus and the fallopian tubes. A small incision is made in the abdomen, and a laparoscope (a small camera) is inserted for examination. Sometimes, a catheter (a flexible tube) is inserted into the vagina and cervix, and a contrast dye is pumped to check for blocks in the fallopian tubes.
How Is Hydrosalpinx Treated?
Proper treatment can improve the chances of becoming pregnant. The treatment option depends on factors like age and the severity of the block. It includes the following treatment methods:
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Antibiotics are given if an active infection is present.
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The salpingostomy (neosalpingostomy) procedure repairs the block in the fallopian tubes. Salpingostomy is a laparoscopic procedure. In this technique, a small surgical cut is made in the fallopian tube to drain the fluid. The damaged parts of the fallopian tube can be removed, and the sealed ends of the tube can be opened. A small amount of damage can be repaired, but in case of severe damage, the fallopian tubes are removed. However, the risk of miscarriage and pregnancy complications increases after this surgery. Therefore, IVF is opted for as it has a better success rate compared to salpingostomy. Though the IVF method can opt for pregnancy, treatment for hydrosalpinx is essential.
Conclusion
Hydrosalpinx is a condition in which the fallopian tubes are damaged and blocked due to fluid buildup. An untreated hydrosalpinx causes life-threatening complications and reduces the chances of pregnancy. Early diagnosis and intervention prevent the risk of complications and improve the chances of pregnancy. Reducing the risk of sexually-transmitted infections can help avoid a hydrosalpinx. Practicing safer sex can help decrease the risk of an infection that affects and damages the reproductive organs.
