Hydrosalpinx: Treating Complications From a Blocked Fallopian Tube
Medically reviewed by Cordelia Nwankwo, MD
Hydrosalpinx is a fluid blockage in a fallopian tube. It often occurs at the far end of the tube, near the area where the tube connects to your ovary. It can be a problem if you are trying to conceive.
A fallopian tube provides the egg's pathway when it leaves your ovary. It is a meeting place for the egg and sperm. It also allows the fertilized egg to travel to your uterus. A blockage can prevent the egg from making that journey.
A damaged tube can remain without causing symptoms. However, it can affect your chances of getting pregnant, even if you use in vitro fertilization (IVF). Fixing the blockage before IVF is often advised.
This article explains how hydrosalpinx affects your fallopian tubes. It also describes causes, symptoms, treatments, and what to expect after treating this problem.
Charday Penn / Getty Images
Hydrosalpinx on Ultrasound: Fallopian Tube Effects
A hydrosalpinx is usually easy to identify with transvaginal ultrasound. This test uses sound waves to create detailed images of internal areas of your body.
A transvaginal ultrasound uses a transducer (a small, lubricated probe slightly larger than a tampon) that is inserted into your vagina. The transducer uses sound waves to create images of your fallopian tubes and other pelvic organs.
Hydrosalpinx on ultrasound appears as a swollen and distended fallopian tube with a sausage-like appearance. The blockage often has what's known as a "waist sign," distinctive indentations along the walls of the tube, making it look like a human waist.
When identified via ultrasound, hydrosalpinx can also show the following characteristics:
Incomplete septa (a wall dividing the fallopian tube into smaller areas) that occur from the fallopian tube folding upon itself
Thickened longitudinal folds that have a cogwheel (like a gear) appearance when imaged on ultrasound
Diagnosis of hydrosalpinx can also be done using a hysterosalpingogram (HSG) test. During this procedure, your uterus is filled with a dye that is administered through your cervix (the neck of the womb) to provide visual contrast. The uterus is then examined using an X-ray to see where the liquid goes or if a blockage traps it.
Two Types of Adnexal Masses: Hydrosalpinx and Ovarian Cyst
An adnexal mass is a growth that develops in the female pelvic region. Hydrosalpinx and ovarian cysts are two types of adnexal masses.
They both trigger inflammation in the reproductive organs and can sometimes be difficult to differentiate clinically and in imaging studies.
A hydrosalpinx is fluid that causes a blockage in a fallopian tube, usually near the uterus. An ovarian cyst is a fluid-filled sac that forms on or inside an ovary.
Causes of Hydrosalpinx
About 30$ to 40% of women diagnosed with infertility have damaged or blocked fallopian tubes. Hydrosalpinx is the most common tubal disease leading to infertility.
Hydrosalpinx causes, and risk factors include the following:
Pelvic inflammatory disease (PID): PID usually results when a sexually transmitted infection (STI) like chlamydia, gonorrhea, or another type of infection goes untreated. The infection causes inflammation of the fallopian tubes.
Endometriosis: Endometriosis is a chronic condition in which your endometrium (tissue similar to the lining of your uterus) grows outside your uterus on other pelvic organs. Endometriosis that develops near your fallopian tubes can scar or block the tubes.
Past surgery: Past surgeries, especially those for uterine fibroids, endometriosis, or abdominal conditions like appendicitis, can result in adhesions (bands of scar tissue) or inflammation in the fallopian tubes, eventually resulting in closure.
Ectopic pregnancy: An ectopic pregnancy occurs when a fertilized egg implants in your fallopian tubes instead of your uterus. Since the egg does not have room to grow, it typically ruptures the fallopian tube. Surgery to repair the tube can lead to scarring in the fallopian tube.
Hydrosalpinx Symptoms: How to Tell
The primary symptom of hydrosalpinx is infertility. However, hydrosalpinx often exists without symptoms. It is common to be unaware you have a blocked fallopian tube until your healthcare provider finds it during tests to identify the cause of your infertility.
When symptoms occur, they can include the following:
Regular or constant pelvic or lower abdominal pain that may worsen during and after your period
Unusual vaginal discharge
Infertility Treatment Options for Hydrosalpinx
Research shows that people with hydrosalpinx have embryo implantation and pregnancy rates that are 50% lower than those of people without the condition.
Hydrosalpinx creates a combination of mechanical and chemical factors that disrupt the fallopian tube and the uterine environment. It is also believed that the hydrosalpinx fluid has a toxic effect on the embryo and receptivity to the embryo in the uterus.
The problem also reduces the rate of pregnancy in IVF, a procedure in which an egg is removed, fertilized, and replaced in the womb. This procedure bypasses the blocked fallopian tube in establishing a pregnancy. However, studies show that having certain hydrosalpinx treatments before IVF can double its success rate.
The type of treatment you have for hydrosalpinx depends on the cause and severity of your blockage and other factors related to the health of your reproductive organs. The following treatments are most commonly used:
Nonsurgical
Nonsurgical options include:
Tubal cannulation: Tubal cannulation involves inserting a catheter through your vagina and using ultrasound guidance to locate the blockage. A small balloon or wire at the end of the catheter is used to remove the blockage.
Sclerotherapy: Sclerotherapy draws the fluid out of the affected tube using an ultrasound-guided needle. A special chemical called a sclerosing agent is then injected to prevent the fluid from building up again.
Surgical
Surgical options include:
Salpingectomy: Salpingectomy involves the surgical removal of the affected fallopian tube. Both fallopian tubes may be removed at the same time if needed.
Salpingostomy: Salpingostomy repairs the blockage in your fallopian tubes by making a small incision into your fallopian tube to drain it. A new fallopian tube opening is created near the ovary so eggs can travel through the new opening to the repaired fallopian tube.
Laparoscopic surgery: Laparoscopic surgery is a surgical technique that uses a long, thin, camera-equipped surgical tool called a laparoscope. It is inserted into your pelvis through one or more small incisions to remove scar tissue, adhesions, or endometrial tissue from the fallopian tube.
After Hydrosalpinx Surgery
If you have hydrosalpinx surgery, you can expect to stay in the hospital for two to three days. It will take about four to six weeks for a full recovery. Complications of these surgeries include the growth of new fallopian tube scar tissue and a higher risk of ectopic pregnancy.
Like any surgery, hydrosalpinx surgery also includes the possibilities of the following complications, which could jeopardize your recovery and outcomes:
Hemorrhage (rapid blood loss)
Damage to organs or tissue
Anesthesia reaction
Nonsurgical options typically involve less downtime and reduce the risk of complications.
Factors such as your age, the amount of tubal scarring, and the severity of other fertility conditions affect your chances of getting pregnant after hydrosalpinx surgery.
Research shows that women who had blockages near the uterus rather than structural blockages or scarring have a better chance of getting pregnant. Having fallopian tubes at least 7.5 centimeters (cm) long after tubal surgery can also make you more likely to conceive.
If you have blocked fallopian tubes that are not treatable, you may still benefit from IVF. Your healthcare provider can help you determine the procedure to provide the best outcomes based on your condition.
Resources and Support
Hydrosalpinx is just one of many factors that can interfere with your ability to become pregnant naturally or with artificial reproductive technologies like IVF. About 10% of U.S. women between the ages of 15 and 44 have problems getting pregnant or staying pregnant.
If you are dealing with infertility for any reason, you may benefit from resources that can provide education and access to the proper care, local support groups, and online communities.
Talk to your healthcare provider to learn about local resources. Many hospitals and fertility providers sponsor support groups for their patients. Or, investigate the following national organizations for local and online resources:
Summary
Hydrosalpinx is a common problem that involves a fluid blockage in your fallopian tube. It often occurs without symptoms, so you may have it and not know it exists.
Hydrosalpinx can become a problem if you are trying to get pregnant. Damaged or blocked fallopian tubes are a common cause of female infertility. A blocked fallopian tube prevents smooth passage of the egg before and after fertilization.
Hydrosalpinx can cause a setback to getting pregnant. However, knowing you have it can allow you to research your options and begin treatment. Research shows that treating this problem before trying to get pregnant on your own or with IVF can increase your chances of getting pregnant.
Read the original article on Verywell Health.
