Hydrosalpinx on the right is treated without surgery. Hydrosalpinx is a severe complication of inflammation of the appendages

What is Hydrosalpinx? This question arises for almost all women who have been given such a tricky diagnosis. If we leave complex medical terms aside, then we can say otherwise that this is dropsy of the fallopian tube (oviduct). Yes, yes, a bag of liquid has formed on the pipe, the dimensions of which vary widely.

Sometimes, after removing a pathological formation, a woman is shown just a huge “bubble” with a cloudy liquid, reaching the size of a small children’s ball. The female reproductive system is a fairly complex and precise structure, which in its normal state provides ideal conditions for conceiving a new life.

It is no coincidence that oviducts got their name. They are the real path along which the egg or zygote (newly born fetus) “goes” into the uterine cavity. What if this path suddenly became impassable? Then pregnancy becomes impossible, and the woman’s doctors are forced to make a terrible diagnosis - Infertility. When making this diagnosis, the ICD code 10 - N70.1 is prescribed in the medical history.

Chronic hydrosalpinx

Chronic hydrosalpinx on the left or right is an already advanced stage of the disease. It is characterized by a “blurred” clinical picture, it proceeds almost unnoticed, causing irreparable harm to the woman’s reproductive system. The constant presence of inflammation and exudate disrupts the functioning of the fallopian tubes. They lose their contractility and elasticity.

But the biggest pathological changes concern the ciliated layer of the oviduct. Cilia, small projections on the lining of the reproductive organ, are designed to help a fertilized egg reach the uterus. They seem to roll over the zygote, because it is deprived of organs of movement. But when dropsy occurs, the eyelashes stick together, and therefore their natural function is disrupted.

Bilateral hydrosalpinx is becoming more common these days. This diagnosis indicates that the oviducts are affected on both sides (Hydrosalpinx on the right, on the left). Bilateral damage to the reproductive system sharply worsens treatment prognoses and increases the risk of infertility. According to statistics, right-sided and left-sided lesions of the fallopian tubes occur with the same frequency.

What is valve hydrosalpinx

It happens that the commissure blocks the oviduct, but the connective tissue has a softer, more pliable consistency. As liquid accumulates in the pipe, the pressure inside the cavity increases many times, which leads to overstretching of the walls.

The fluid begins to put pressure on the connective tissue with such force that the adhesion cannot withstand, and it becomes possible for the outflow of exudate, which breaks either into the uterine cavity or into the abdominal cavity.

Everything described above occurs with valve hydrosalpinx! The fallopian tube becomes partially patent, which in many cases helps a woman become pregnant. Hundreds of cases have been documented in which women became mothers even with enormous amounts of dropsy.

But a fluid breakthrough can also cause irreparable harm, especially when using IVF (in vitro fertilization). An embryo conceived outside a woman's body and then transferred to her uterus can simply be washed away by the flow of exudate. Thus, all the efforts of reproductive specialists (artificial insemination doctors) fail. That is why it is increasingly recommended to surgically remove dropsy of the fallopian tube before conception “in vitro”.

Causes of Hydroalpinx

The mechanism of occurrence of the disease has not been fully studied, but the causes of Hydrosalpinx include:

• congenital abnormal development of the organs of the reproductive system;
• disruption of the movement of lymph along the lymphatic tract;
• abdominal operations;
• previous ectopic pregnancy;
• pathological growth of the endometrium;
• perforated appendicitis;
• adhesive disease in the pelvic area;
• poor circulation and/or chronic foci of inflammation in the reproductive organs;
• previously suffered sexually transmitted diseases, especially Chlamydia and Gonorrhea;
• some intestinal pathologies.

The causes of bilateral Hydrosalpinx are identical to the above points.

Symptoms of Hydrosalpinx

The symptoms of Hydrosalpinx are very varied. These include:

• watery vaginal discharge. They may have a cloudy or serous-purulent structure;
• nagging pain in the area of ​​projection of the appendages. Their intensity is medium;
• When the disease worsens, women note a fairly sharp rise in temperature to 39 degrees. Celsius.

Much less common are prolonged rise in temperature, unexplained weakness, fatigue, poor general health, and depressive psychological conditions that are difficult to treat. These signs are identical for both Hydrosalpinx on the right and on the left.

All signs of Hydrosalpinx can appear with varying degrees of intensity, which increases the risk of incorrect or delayed diagnosis. Sometimes the woman herself delays the gynecological consultation, only aggravating her situation.

Why is the disease dangerous?

Consequences of Hydrosalpings:

• primary or secondary infertility;
• ectopic pregnancy;
• rupture (perforation) of the oviduct with internal bleeding;
• addition of infection and suppuration of exudate.

Differential diagnosis

Today, various methods for differential diagnosis of the disease are available. These include:

• Ultrasound (ultrasound examination). Hydrosalpinx on ultrasound looks like a liquid pathological inclusion, localized in the space between the ovary and the uterus itself. This echo sign is a decisive factor in making this diagnosis;
• gynecological examination;
• hysterosalpingography (hydrosalpingography (HSG);
• laparoscopy. It should be noted that laparoscopy can not only identify hydrosalpinx, but also cure it.

Conservative treatment

Treatment without surgery is the first step towards getting rid of the disease. To combat the inflammatory process, treatment with broad-spectrum antibiotics is used. Such drugs are prescribed not only in injections, but also in tablets and suppositories, which only simplifies treatment. Longidaza must be prescribed as a drug ideal for treating this disease.

To mobilize the body's own strength, general strengthening, vitamin, absorbable preparations and medications that remove excess fluid from tissues are additionally prescribed. The effect of drugs is enhanced by physiotherapeutic procedures and laser therapy.

Treatment of Hydrosalpinx: auxiliary methods

Sanatorium-resort treatment is especially indicated for women with chronic bilateral hydrosalpinx. Mud baths have a powerful absorbing effect, which will certainly be beneficial for this disease. After all, if the fallopian tubes restore patency, then the likelihood of pregnancy will increase many times over.

Homeopathy is another auxiliary method of treating the disease. The benefits of taking homeopathic medicines are very controversial, have no evidence base and are not accepted by official medicine. But, after a detailed consultation with a specialist, you can try this method of defeating the disease.

On the forms of those women who have cured the disease, one can increasingly see positive reviews about treatment with leeches. Even wise Chinese healers for thousands of years saved women from diseases of the reproductive system through the use of a special type of leeches. Then this technique was undeservedly forgotten, but today it is experiencing a real “boom” in popularity.

This pathology has long been treated with propolis. To prepare the tincture, use only high-quality raw materials or buy a ready-made product at the pharmacy. For home preparation, take medical alcohol (60%) and mix it with crushed propolis (40%). Use the tincture to rub the skin of the abdomen on the affected side.

In folk medicine, decoctions of anti-inflammatory herbs are used as medicinal microenemas. Juice treatment, which is combined with clay therapy, is actively used.

It should be remembered that traditional medicine cannot become the main treatment even if a mild degree of this pathology is detected. Folk remedies are just an addition to complex treatment!

Treatment of hydrosalpinx disease with surgery

Sometimes it happens that treatment of Hydrosalpinx can only be continued through surgery - removal of the dropsy. When removing Hydrosalpinx, a gentle technique is most often used - laparoscopy.

To carry it out, the latest optical technology is required, through which dropsy is removed without opening the abdominal cavity, which minimizes the risk of postoperative complications, reduces the likelihood of developing adhesions and bleeding, and does not cause serious cosmetic defects.

After the stage of removing the dropsy, the surgeon performs plastic surgery of the oviduct, restores its patency, excises adhesive scars and restores re. Laparoscopy of Hydrosalpinx has a number of contraindications, which the gynecologist treating you will definitely warn you about.

Some women suffer from a real phobia that prevents them from having surgery on time and finding the joy of motherhood. In such cases, a competent gynecologist will definitely advise you to visit thematic forums where you can casually communicate with people who have overcome identical problems.

On such sites you can look at photos and listen to videos about the stages of surgery, get acquainted with the symptoms and duration of the postoperative period, and find out the norm of laboratory tests. But if fear remains an insurmountable obstacle, then, without hesitation, you should go to a professional psychologist.

Conclusion

As you can see, Hydrosalpinsk is a very serious illness, therefore disease prevention should be dealt with immediately after the birth of a girl. It is the responsibility of parents to teach a girl or teenager to take care of their health. The child must understand the importance of reproductive health, so do your best to convey useful information to him. The woman comes from childhood. And if childhood and adolescence are passed in compliance with all the rules for preventing the disease, then the risk of developing pathology in adulthood is reduced significantly.

The most interesting on the topic

Hydrosalpinx (from ancient Greek ǔδωρ - “water” and σάλπιγξ - “pipe”) is a one- or two-sided saccular expansion of the fallopian tube, filled with a clear serous non-infected fluid (transudate), formed against the background of inflammation due to soldering of the ampullary part of the fallopian tube.

Approximately a third of patients with confirmed tubal infertility are diagnosed with this pathological condition. In addition to reducing the likelihood of a natural pregnancy (by approximately 50%), hydrosalpinx worsens the prognosis for implantation of a fertilized egg during in vitro fertilization (IVF), and increases the frequency of ectopic pregnancies and miscarriage (on average, 2 times).

Hydrosalpinx is a pathology in which the patency of the fallopian tubes occurs.

Causes and risk factors

The cause of the accumulation of serous fluid in the lumen of the fallopian tube is its inflammation, which develops as a result of the following diseases and conditions:

• inflammatory process in the fallopian tubes, ovaries (salpingitis, salpingoophoritis);
• endometritis, endometriosis;
• sexually transmitted infections;
• long-term wearing of an intrauterine device;
• therapeutic and diagnostic manipulations on the fallopian tubes and uterus;
• acute or chronic inflammatory diseases of the vagina, cervix;
• the presence of space-occupying formations in the uterine cavity;
• congenital anomalies of the fallopian tubes;
• tuberculosis of the genital organs.

Normally, the fallopian tubes are hollow muscular tubular organs from 7 to 12 cm long, extending in both directions from the uterus towards the ovaries. One end of the fallopian tube is connected to the uterine cavity by the uterine opening, the other, expanding in a funnel shape, opens in the abdominal cavity in close proximity to the ovary. The funnel of the fallopian tube is bordered by fimbriae (fimbriae), which, making sweeping movements, move the fertilized egg into the lumen of the tube in order to transport it to the uterine cavity.

The mucous membrane lining the lumen of the tubes from the inside has longitudinal folds, contains cells that produce a special secretion, and microscopic motile cilia; The pipes themselves perform peristaltic movements (contractions). These adaptive mechanisms contribute to the advancement of the egg to the implantation site.

Approximately a third of patients with confirmed tubal infertility are diagnosed with hydrosalpinx.

During inflammatory processes, adhesions form in the fallopian tubes, impairing their peristaltic activity and disrupting the drainage of secretions inside the oviducts. The fimbriae of the infundibulum stick together with each other and with the surrounding tissues, blindly closing the lumen of the tube (the initial part of the organ in contact with the uterine cavity may also undergo similar changes). As a result, the fallopian tube from the organ that conducts the egg from the ovary to the uterus turns into a closed formation, where mucus accumulates and secondary inflammatory changes develop. The fallopian tubes in this case are functionally incompetent.

Forms

Depending on the morphological manifestations, hydrosalpinx occurs:

• single-chamber (this is a spindle-shaped, oval or S-shaped formation, the longitudinal size of which is 2-3 times larger than the transverse one);
• multi-chamber (from 2 to 8 closed cavities are observed, located one after another in the form of a chain).

If the adhesive process is not active enough and the gluing of the fimbriae of the funnel of the tube or its initial section is not tight, the hydrosalpinx may break through into the pelvic cavity or into the uterine cavity during straining or intense physical activity. In such a situation, they speak of ventilated (drainable) hydrosalpinx.

According to the involvement of the fallopian tubes there are:

• unilateral hydrosalpinx;
• bilateral hydrosalpinx.

With the flow:

• spicy;
• chronic.

Symptoms

Symptoms of chronic hydrosalpinx are usually nonspecific:

• nagging, bursting, low-intensity pain in the iliac region;
• periodically occurring watery discharge (when a drained hydrosalpinx breaks into the uterine cavity);
• low-grade body temperature;
• pain or discomfort during sexual intercourse;
• nagging pain in the lower abdomen when the adhesive process spreads into the pelvic cavity (periodically breaking through valve hydrosalpinx);
• menstrual irregularities;
• inability to get pregnant.

Often, hydrosalpinx is asymptomatic for a long time and is diagnosed during an examination for infertility or when acute complications develop.

In an acute, intensively growing process, the pain acquires a pronounced pulsating character, a significant rise in body temperature is possible, and symptoms of intoxication are added (headache, loss of appetite, drowsiness, deterioration in general well-being).

Diagnostics

The basis for the diagnosis of hydrosalpinx is the results of a gynecological examination and data from instrumental research methods:

• bimanual vaginal examination;
• Ultrasound examination with a transvaginal sensor;
• X-ray examination (hysterosalpingography);
• laparoscopy;
• magnetic resonance or computed tomography (if it is difficult to make a diagnosis).

Laboratory research methods (general and biochemical blood tests, general urine analysis) are not indicative, since there are no laboratory criteria for the disease.

Often, hydrosalpinx is asymptomatic for a long time and is diagnosed during an examination for infertility or when acute complications develop.

Treatment

Treatment of hydrosalpinx begins with conservative methods:

• etiotropic therapy (antibacterial, antimicrobial drugs);
• strengthening the immune system (immunostimulants);
• vitamin therapy;
• physiotherapeutic procedures (magneto- and electrophoresis, ultraviolet irradiation, electrical stimulation, etc.).

If conservative measures are ineffective, surgical treatment is indicated (in the vast majority of cases, endoscopic):

• salpingo-ovariolysis (dissection of adhesions in the pelvis, restoration of patency of the fallopian tubes);
• fimbryolysis and fimbryoplasty (elimination of adhesions in the area of ​​the fimbriae of the fallopian tubes);
• salpingostomy and salpingoneostomy (formation of a new opening for the exit of the fallopian tube);
• tubectomy (removal of a tube or tubes, performed if it is impossible to restore patency when other treatment measures are ineffective).

Possible complications and consequences

Complications of hydrosalpinx can include:

• suppuration of hydrosalpinx (pyosalpinx);
• adhesions in the pelvic cavity;
• ectopic (tubal pregnancy);
• miscarriage;
• infertility;
• in the case of IVF – ineffectiveness of the procedure, spontaneous termination of the resulting pregnancy;
• rupture of the fallopian tube.

Forecast

Even with successful restoration of patency and elimination of the adhesive process, in the case of long-term, sluggish inflammation, the full functional viability of the pipes is significantly reduced, since the microvilli of the mucous membrane lose their proper mobility and peristalsis slows down. Patients who have undergone salpingo-ovario- or fimbryolysis in this situation are at risk for tubal (ectopic) pregnancy.

When tube patency is restored and acute hydrosalpinx is removed, natural conception and pregnancy occur in approximately 75% of cases, and the probability of an ectopic pregnancy does not exceed 5%.

Prevention

The following measures must be observed:

1. Timely treatment of inflammatory diseases of the pelvic organs.
2. Prevention of sexually transmitted infections.
3. Comprehensive examination in case of infertility or recurrent miscarriage.

Video from YouTube on the topic of the article:

Treatment of this disease can be carried out either surgically or conservatively. Conservative methods of treatment include localization of inflammatory processes, using physiotherapy and medications, as well as blowing out the fallopian tubes mechanically.

A hydrosalpinx is an accumulation of fluid in the fallopian tubes due to injury or infection. This fluid has a pale yellow tint and is called transudate. In this article we will look at the causes of hydrosalpinx, as well as possible treatment methods.

The classic causes of hydrosalpinx are chlamydia or gonorrhea. These infections can go unnoticed for many years, slowly destroying the thin lobular fimbriae. As a response to injury, the body rushes inflammatory cells to the area of ​​inflammation. The inflammatory process can lead to loss of fimbriae and “blockage” of the fallopian tube. These infections usually affect both fallopian tubes.

Not only is hydrosalpinx a cause of infertility, but the condition can also reduce the success rate of infertility treatments, even those procedures that do not involve the fallopian tubes.

Diagnosis of hydrosalpinx

There are several ways to diagnose this disease:

1. Ultrasound. During the procedure, a narrow probe is inserted into the vagina. Healthy fallopian tubes are usually not visible on an ultrasound, but a tube filled with fluid will appear larger, thus standing out from the rest. Ultrasound is a brief, non-invasive and painless test and is often used in the initial assessment of the ovaries, uterus and fallopian tubes.

2. Hysterosalpingogram. This is an x-ray method in which a small amount of dye is injected into the uterus and fallopian tubes. The dye seeps through the uterus, making any changes easy to visualize. If the fallopian tubes are open, fluid passes through them into the surrounding areas of the abdomen. In the case of a blockage, such as a hydrosalpinx, the dye will not be able to exit the fallopian tubes and the tubes will appear stretched. A hysterosalpingogram is performed in the second week of the menstrual cycle (that is, after menstrual bleeding has stopped, but before ovulation). The whole procedure takes about 10 minutes. Side effects are possible - in the form of pain in the pelvic area or cramps. Ibuprofen taken before the procedure will help manage these side effects. Most women can begin work or household chores immediately after the procedure.

3. Laparoscopy is a surgical procedure performed using a laparoscope. It is a thin instrument equipped with a tiny surveillance camera. The laparoscope is inserted into the pelvis through a microscopic incision in the navel, allowing the surgeon to directly see the fallopian tubes on a screen. In some cases, laparoscopy may be used to confirm a previous diagnosis of hydrosalpinx or for other conditions. Because this surgical procedure requires general anesthesia, it is usually not used for initial diagnosis.

Hydrosalpinx: causes of occurrence

The causes of the disease are different, we list the main ones:

• endometriosis;
• ovulation induction;
• inflammatory diseases of the pelvic organs (for example, chlamydial or gonococcal infections). Hydrosalpinx occurs most often when adhesions occur from inflammatory diseases of the pelvic organs;
• unilateral or bilateral hydrosalpinx can occur in women after hysterectomy, when only the fallopian tubes are involved in the blood supply to the ovary;
• with the accumulation of uterine secretions caused by surgery;
• after a tubal ligation procedure;
• for malignant primary or secondary tumors of the fallopian tubes.

Most often, hydrosalpinx is asymptomatic. During the acute stage of the disease, body temperature can rise to 39ºC. The patient experiences weakness, severe fatigue, throbbing and bursting pain in the pelvic area. Tachycardia and increased heart rate are possible. The size of the inflamed area can reach several centimeters.

Treatment of hydrosalpinx without surgery

Treatment methods for this disease can be either conservative or surgical. Conservative treatment is carried out using medications - immunocorrective drugs. A treatment method such as autohemotherapy will also be effective. During the procedure, blood is taken from a vein from the patient and this blood is injected intramuscularly or subcutaneously.

Treatment of hydrosalpinx without surgery is carried out using physiotherapeutic methods of treatment, such as UV irradiation, electrophoresis with magnesium or potassium iodide, UHF therapy. But, as practice shows, treatment of hydrosalpinx without surgery is not particularly effective, since this disease is a mechanical obstacle, so surgical intervention is necessary.

Surgery to remove hydrosalpinx

For small hydrosalpinx, surgical treatment methods are often prescribed. During the procedure, the transudate accumulated in the tube is mechanically removed, after which there is a high probability of becoming pregnant naturally. During the operation, the surgeon makes a small incision in the abdomen and removes fluid that has accumulated in the fallopian tubes. Recovery from this procedure is relatively quick, and the patient can return to normal life within a few days.

Due to the fact that after 35 years the reproductive qualities of the ovaries decrease, this operation is recommended for younger patients. After surgery, the risk of ectopic pregnancy increases. Therefore, girls who want to get pregnant naturally should regularly visit a doctor who will monitor the fertilization process and be able to identify pathology in time.

Due to the fact that after surgical reconstruction of the fallopian tubes, the rate of natural pregnancy is not that high (studies have shown about 10%), and also due to the increased risk of developing an ectopic pregnancy, most women prefer IVF fertilization.

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

Medicines to slow down the formation of hydrosalpinx

• Antibiotics for hydrosalpinx:

1. Ampicillin - diluted with novocaine or saline, administered as an intramuscular injection of 0.5 g 4 times a day;
2. Apmiox – take two capsules orally 4 times a day;
3. Ecocephron - take 1-2 capsules orally 3-4 times a day;
4. Cefotaxime - administered intramuscularly, 1000 mg every eight hours;
5. Metronidazole – take 1 tablet up to 4 times a day;
6. Furazolidone - take 2 tablets 4 times a day against the background of basic antibiotic therapy.

To prevent dysbiosis, antibiotic therapy is carried out while taking antifungal agents and probiotics (Ketoconazole, Linex, etc.).

• Non-steroidal anti-inflammatory drugs:

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

To potentiate the drug effect and strengthen the immune system, treatment is supplemented with vitamin supplements.

• Vitamins, immunomodulators and complex vitamin preparations:

1. Ascorbic acid – take 0.5 g per day, daily;
2. Tocopherol - take 0.1 g daily for a couple of weeks;
3. Cocarboxylase – administered as an intramuscular injection, 1-2 ampoules daily;
4. Immunofan - administered intramuscularly, one ampoule per day, for three weeks.

• Longidaza is prescribed for hydrosalpinx because of the drug’s ability to effectively eliminate adhesions in the pelvis. In addition, Longidaza significantly increases the bioavailability of other medications. The product 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 range from five to fifteen injections. If the doctor prescribes suppositories, 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 for hydrosalpinx complement each other, enhancing the effect of treatment: as a result, adhesions are successfully resolved and the inflammatory reaction subsides.
• Ceftriaxone for hydrosalpinx helps to avoid purulent complications, abscess, etc. The drug is administered intramuscularly, in an individually determined dosage. Ceftriaxone should not be used if you have hypersensitivity to cephalosporins and penicillin antibiotics. Side effects include nausea and the development of thrush (as a result of antibiotic therapy in general).
• Cifran is prescribed for hydrosalpinx, taking into account the drug’s ability to successfully fight gynecological infectious diseases. Most often, Cifran is administered orally in a dosage of 500 mg twice a day, regardless of meals. The duration of the treatment course is about one week. Adverse symptoms are usually mild and include nausea, diarrhea, loss of appetite, and sometimes allergies.
• Suppositories for hydrosalpinx are prescribed to almost all patients, the only difference is in the mechanism of action of these forms of drugs. For example, suppositories can have an anti-inflammatory effect (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 suppositories for hydrosalpinx are used 1-2 times a day for 10 days (unless the doctor has prescribed another treatment regimen). This remedy has virtually no contraindications (with the exception of allergies) and has been successfully used for many years to treat salpingitis, endometritis, erosions, colpitis and other gynecological problems. In terms of antiseptic effect, ichthyol is equal to Vishnevsky ointment.
• Recently, many websites strongly recommend using so-called “Chinese tampons” to treat gynecological problems. Such products supposedly have a special medicinal impregnation that affects the pathological focus directly at the site of application. It should be noted right away that such means are not officially recognized in our country, so there is no need to rush to use them. There are already quite a few cases where Chinese tampons did not cure hydrosalpinx, but caused a lot of other problems - irritation of the mucous membrane, bacterial imbalance, colpitis, etc. It would be prudent to make plans for self-medication and consult with a competent doctor.
• Gynecological garlic tampons for hydrosalpinx are made from crushed cloves of garlic and warm water (water with garlic is filtered through gauze). A homemade gauze swab is moistened with the resulting water and inserted into the vagina for no more than two hours. It is believed that this time is enough for the active substances contained in garlic to exert their therapeutic effect. This method has its fans and those who categorically reject it. Indeed, this product can cause severe irritation of the mucous membrane, even burns. Therefore, if you decide to use it, you should definitely discuss this treatment with your doctor first.
• Contraception - for example, Regulon for hydrosalpinx has virtually no therapeutic purpose. Such drugs are used both for contraception and for regulating the monthly cycle and getting rid of endometriosis. These medications do not affect the fact of hydrosalpinx in any way.
• Sodium thiosulfate for hydrosalpinx can be used when the pathological focus is suppurated - in this case, the solution has a pronounced antitoxic effect. 2-3 g of the drug are prescribed orally in the form of a 10% solution (mixed with saline). Possible intravenous administration (as prescribed by a doctor).
• Vilprafen for hydrosalpinx is prescribed as an antibacterial treatment, especially if the patient is contraindicated for certain antibiotic therapy (for example, with an allergy to penicillins). Vilprafen is taken 2-4 tablets per day (in 2-3 doses). As a rule, the course of therapy does not exceed ten days.
• The dietary supplement Ginecol for hydrosalpinx helps inhibit the inflammatory process and potentiates regeneration. The drug is taken for three months, two tablets per day, after consulting with a doctor in advance. Gynecol is not considered a drug, so it is taken only against the background of the general prescribed treatment.
• Terzhinan plays the role of a powerful antiseptic and antibacterial agent for hydrosalpinx. The tablets are administered intravaginally, one tablet 1-2 times a day. Treatment continues for 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.
• Catedzhel for hydrosalpinx is used topically due to the content of chlorhexidine in the drug, which has strong bactericidal activity. This drug is not intended for self-use. It is used only by a doctor or specially trained medical personnel, according to a predetermined treatment regimen.

Physiotherapeutic treatment

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

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

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

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

Traditional treatment

In addition to the basic therapy prescribed by the doctor, alternative treatments can also be used. This will help the body fight the disease with renewed vigor, enhancing the effect of other medications.

Potato juice will help stop the growth of capsule formation. 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 water. The seeds are poured with water, brought to a boil over low heat and removed from the heat to infuse. Take the resulting and filtered decoction, 100 ml every 2-3 hours.

Potato juice and flax decoction for hydrosalpinx are considered the “number one” remedies. They can be combined together: in this case, the treatment will be even more effective.

Also, many people drink medicine based on the herb St. John's wort. It is prepared like this: first, steam 1 tbsp. l. raw materials in 200 ml of boiling water, leave for 1 hour. Next, place on fire, bring to a boil and keep on low heat for another quarter of an hour. After this, the medicine is cooled, filtered and drunk on an empty stomach three times a day, 5 tbsp. l.

Some sources claim the positive effect of hirudotherapy. However, most experts are confident that leeches will not completely eliminate hydrosalpinx, but will only give a temporary effect. The functionality of the tubes can only be partially restored by surgery. 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 ointment for hydrosalpinx eliminates the adhesive process - the main cause of the disease. Ointment alone is not enough for successful treatment: it is also necessary to prepare a medicinal mixture from equal quantities of eucalyptus leaves, chamomile flowers, calendula, and oak bark. Pour boiling water over 1 tbsp. l. collection, insist for half an hour. The infusion is filtered and douched (the liquid should be warm) overnight, and immediately after the procedure, a tampon treated with Vishnevsky ointment should be inserted into the vagina. A tampon is made manually (a regular store-bought one will not work) from a sterile bandage and thread. The procedures are repeated daily for three weeks.

Before starting any independent treatment, you must first consult a medical specialist.

Herbal treatment

• Knotweed herb is rightfully considered a good restorative agent in gynecology. Medicine from this plant is prepared using this method. Brew 5 tbsp in 1000 ml of boiling water. l. knotweed, cover with a lid and a warm scarf and leave for about 40 minutes. Next, the infusion is filtered and drunk throughout the day - for example, instead of tea. This treatment lasts at least a month, after which you should take a break of 10-14 days.
• Anise seeds in an amount of 100 g are mixed with 1 liter of honey and kept for three days at room temperature. Take the drug 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). Such treatment can last until the condition improves.
• The boron uterus is used for hydrosalpinx as often as for other gynecological problems. To make an infusion, take 10 g of the plant, brew it in boiling water (200 ml) and leave for 20 minutes. Use 1 tbsp. l. infusion 5 times a day. You can also buy a ready-made alcohol tincture of boron uterus at the pharmacy: drink it with water, 30 drops three times a day between meals. The course of treatment using the boron uterus should last three months.

Homeopathy

The homeopathic treatment program is selected during an individual consultation. During the first few days, homeopathic medicines may cause a slight deterioration in the condition in the form of headaches, nausea, and general weakness. Within a few days, your health will return to normal.

The most widely used homeopathic remedies are:

• Lachesis - prescribed for inflammatory processes in the genital area;
• Pulsatilla – strengthens the immune system, stabilizes reproductive function;
• Hormel - restores the functioning of the internal genital organs;
• Gynekoheel – promotes the restoration of damaged tissues;
• Apis - 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, and additional sources of magnesium, potassium, and zinc.

Surgery

Surgery is usually recommended for all women diagnosed with hydrosalpinx who plan to become pregnant in the future. Today, laparoscopy is considered the main method of surgical access for this disease. This procedure can have several varieties. The doctor decides what exactly to apply to the patient.

• Tubectomy is the resection of a tube or two tubes. This is an extreme case where no other treatment is considered.
• Salpingostomy involves creating an opening in the uterine tubes to connect them with the abdominal cavity.
• Fimbryolysis aims to free the villi, clear 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. This operation is relatively quick, as is the recovery after it. At the same time, the structure of the organ suffers minimally, which significantly increases a woman’s chances of further pregnancy.

Laser treatment of hydrosalpinx is classified as a physiotherapeutic procedure: such therapy is appropriate if surgery is impossible for some reason. The affected area is exposed to laser light radiation - its power is 5-100 W. Thanks to the procedure, metabolic reactions are optimized, adhesions are softened, and the patient’s chances of pregnancy increase.

– pathology of the fallopian tubes, caused by one- or two-sided accumulation of transudate in their lumen. It can be asymptomatic and first detected in connection with infertility. Clinically pronounced forms of hydrosalpinx are accompanied by pain in the lower abdomen (pulling, bursting, pulsating), profuse watery leucorrhoea, febrility and general weakness. To diagnose hydrosalpinx, a gynecological examination, OMT ultrasound, USGSS and hysterosalpingography, collection and evaluation of smears, and diagnostic laparoscopy are performed. Treatment of hydrosalpinx is most often surgical - salpingostomy, tubectomy.

General information

Hydrosalpinx is a violation of the patency of the fallopian tubes caused by the deposition of serous effusion in them. It is the most common cause of tubo-peritoneal infertility in women. The frequency of detection of hydrosalpinx in patients resorting to assisted reproductive technologies due to tubal infertility is 10-30%. In women with hydrosalpinx, the possibility of spontaneous pregnancy is halved, embryo implantation in IVF procedures is 3-5 times less likely, and cases of miscarriage and the incidence of ectopic pregnancy double. Available statistics demonstrate the extreme relevance of this problem and the search for its solution for obstetrics and gynecology.

Classification of hydrosalpinx

A serious complication of hydrosalpinx can be rupture of the fallopian tube, the occurrence of which is indicated by sudden sharp pain in the corresponding half of the abdomen, tachycardia, arterial hypotension, pale skin, cold sweat. In case of rupture of the pyosalpinx, there is a high probability of developing peritonitis, pelvioperitonitis, and abscess of the pouch of Douglas. In some cases, the breakthrough of pus does not occur in the abdominal cavity, but in the bladder, vagina or rectum.

Hydrosalpinx and IVF

Research in the field of reproductology convincingly proves the negative impact of hydrosalpinx on the prognosis of IVF. At the same time, not only do the chances of successful embryo transfer decrease significantly, but the risks of developing ectopic pregnancy and spontaneous abortion in the early stages also increase. This cause-and-effect relationship is explained by a number of pathological effects that the contents of hydrosalpinx can cause:

• Mechanical action. It is assumed that the draining hydrosalpinx, emptying into the uterine cavity, can “wash out” early embryos.
• Embryotoxic effect. In addition to the direct mechanical removal of embryos from the uterine cavity, the contents of the hydrosalpinx have a destructive effect on them. Liquid from hydrosalpinx contains large quantities of microorganisms and their toxins, lymphocytes, prostaglandins, proinflammatory cytokines, etc., which have a pronounced cytotoxic and embryotoxic effect. This effect persists even with a 50% dilution of the hydrosalpinx contents.
• Endometrial damage. Using morphological and immunohistochemical methods, pathomorphological changes in the endometrium under the conditions of the existence of hydroalpinx were identified. A decrease in local immunity, the expression of receptors for progesterone and estradiol, a decrease in subendometrial blood flow, structural disorders of the glandular and stromal components of the endometrium - any of these factors can cause a violation of embryo implantation.

Diagnosis of hydrosalpinx

Clinical, laboratory and instrumental diagnostics aimed at identifying hydrosalpinx include examination on a chair with collection of smears from the genital tract, examination of the patency of the fallopian tubes, sonography, and laparoscopy. During vaginal examination, a formation of a round or ovoid shape of a tight-elastic consistency, usually moderately painful, may be palpated between the uterus and the ovary.

The most reliable data for the presence of hydrosalpinx can be obtained during diagnostic laparoscopy. At the same time, the monitor shows thickened fallopian tubes with edematous fimbriae, thinned walls of the tube, through which the watery contents are visible. Laparoscopy is also the main component of conservative-surgical management of patients with hydrosalpinx.

Treatment of hydrosalpinx

It is not possible to cure hydrosalpinx only by conservative means. The preservation of pathomorphological prerequisites for the accumulation of transudate determines the recurrent course of the pathology. In addition, the presence of hydrosalpinx casts doubt on the successful implementation of reproductive plans. Currently, all patients with this problem undergo two-stage treatment. First, adequate anti-inflammatory therapy is prescribed, aimed at stopping the activity of the infectious process in the fallopian tubes. Antibacterial drugs, vitamin therapy, physical therapy (electrophoresis of artificial insemination, reproductive specialists recommend laparoscopic tubectomy (salpingectomy) are prescribed. Removal of the fallopian tube increases the effectiveness of the IVF program three or more times.

Forecast and prevention of hydrosalpinx

Hydrosalpinx is associated with low chances of pregnancy, both when trying to conceive independently and as part of IVF protocols. Functional reconstructive surgery does not always allow achieving the desired pregnancy naturally, so the method of choice for a significant proportion of patients is tubectomy followed by an IVF cycle (.

Prevention of hydrosalpinx is the prevention and adequate treatment of PID (salpingoophoritis, endometritis) and STDs, exclusion of casual sexual contacts, refusal of abortions, and regular observation by a gynecologist.