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Understanding Hydrosalpinx: Causes, Symptoms, and Treatment Options


Understanding Hydrosalpinx: Causes, Symptoms, and Treatment Options

Many women may not be familiar with the term “hydrosalpinx,” but it can be a crucial piece of information in understanding fertility challenges. This blog dives into the details of hydrosalpinx, explaining what it is, how it affects fertility, and what treatment options are available.

What is Hydrosalpinx?

Hydrosalpinx is a condition characterized by the accumulation of fluid in the fallopian tubes, leading to blockages, loss of fallopian tube function, causing fertility issues. The term “hydrosalpinx” originates from the Greek words “hydro,” meaning water, and “salpinx,” meaning tube.

What Causes Hydrosalpinx?

Several factors can contribute to the development of hydrosalpinx, including:

Pelvic Inflammatory Disease (PID): One of the most common causes of hydrosalpinx is pelvic inflammatory disease means pelvic infection, which typically results from sexually transmitted infections such as chlamydia or gonorrhea. These infections can cause inflammation and scarring of the fallopian tubes, leading to blockages and fluid accumulation.

Previous Pelvic Surgeries: Surgical procedures involving the pelvis, such as tubal ligation (surgical sterilization) or pelvic surgeries to treat conditions like endometriosis or ovarian cysts, cesarean sections can sometimes lead to scarring or damage to the fallopian tubes, increasing the risk of hydrosalpinx.

Endometriosis: Endometriosis is a condition where the tissue lining the uterus grows outside the uterus, often affecting the ovaries, fallopian tubes, and other pelvic organs. Endometriosis can cause inflammation and scarring of the fallopian tubes, contributing to the development of hydrosalpinx.

Adhesions or Scar Tissue: Any form of pelvic trauma, such as previous surgeries, infections, or inflammatory conditions, can result in the formation of adhesions or scar tissue within the fallopian tubes, leading to blockages and fluid accumulation characteristic of hydrosalpinx.

How Does Hydrosalpinx Affect Fertility?

Hydrosalpinx can hinder fertility in several ways:

Blocked Passage: The fluid buildup and blockage prevent the egg from traveling down the fallopian tube to meet the sperm for fertilization.

Toxic Environment: The fluid can be toxic to both sperm and the embryo, further reducing the chances of conception.

Implantation Issues: Even if fertilization occurs, the fluid can leak into the uterus and interfere with the implantation of the fertilized egg in the uterine lining.

How to Diagnose Hydrosalpinx?


Diagnosing hydrosalpinx typically involves a combination of medical history, physical examination, and imaging studies. Here’s an overview of the diagnostic process:

Hydrosalpinx and IVF: How Does It Impact Assisted Reproductive Technology

Hydrosalpinx can significantly impact the success rates of IVF (In Vitro Fertilization) procedures.

Here’s how hydrosalpinx affects IVF:

Effect on IVF success: Hydrosalpinx can adversely affect the success of IVF treatment in several ways:

Treatment before IVF: In many cases, it’s recommended to surgically correct or remove the affected fallopian tubes (salpingectomy) before undergoing IVF. Removing the hydrosalpinx can improve the chances of success by eliminating the adverse effects it can have on embryo implantation and pregnancy rates.

Salpingectomy vs. tubal occlusion: While salpingectomy (removal of the fallopian tubes) is often recommended to improve IVF outcomes in cases of hydrosalpinx, some studies suggest that simply occluding or blocking the tubes (tubal occlusion) may also be effective. However, the choice between these approaches depends on various factors, including the severity of hydrosalpinx, patient preferences, and the advice of fertility specialists.

Treatment Options for Hydrosalpinx:

The treatment options for hydrosalpinx depend on several factors, including the severity, the desire for future children, and other individual considerations. Some treatment options include:

Medical treatment: There is not much role for medical treatment in an already existing hydrosalpinx. In women with active infection of the hydrosalpinx with pain or fever responds well with antibiotic treatment for symptom relief but the effect on function and tubal quality is questionable.

Laparoscopic surgery:  

 Salphingolysis/Fimbriolysis/ Tubal cannulation: This minimally invasive surgery aims to open the blockage of the fallopian if possible, to restore fertility. Opening of tube is possible depending on various factors like the severity of adhesions, amount of tubal distension with fluid. Tubal function can be tried to be restored if there is minimal adhesion especially at the fimbrial end mostly seen with cases of endometriosis and mild pelvic infection. In some cases even if the fallopian tube is open after surgery there is a risk of having ectopic pregnancy (pregnancy inside the fallopian tube) due to the damage already caused to the tube by the fluid collection.

Salpingectomy: If the fallopian tube is grossly distended with fluid or damaged with scarring or endometriosis then the only option is removing the entire affected fallopian tube called salpingectomy. This option is often considered if the tube is severely damaged or if pregnancy is not desired. Those who desire to have pregnancy the only option is to go for IVF, in case of removal of both the tubes.

Hydrosalpinx Surgery: What to Expect and Recovery

Surgical treatment for hydrosalpinx typically involves minimally invasive methods such as laparoscopy or robotic surgery. During laparoscopic salpingectomy, small incisions, usually around 5 mm in size, are made, though slight variations may occur depending on the surgeon and techniques used. Due to the smaller wounds, post-operative recovery is generally faster, requiring hardly any bed rest, and patients can often return to their normal activities sooner.

Living with Hydrosalpinx: Is Removal of the Fallopian Tubes Always Necessary?

Living with hydrosalpinx can cause various problems, including reduced fertility, an increased risk of ectopic pregnancy, and pelvic pain and discomfort. While surgical removal of the affected fallopian tubes (salpingectomy) is often recommended if the patient experiences symptoms such as pelvic pain or before undergoing assisted reproductive technology like IVF to improve success rates. The decision to remove the tubes depends on factors such as the severity of hydrosalpinx, individual health circumstances, and the patient’s fertility goals. If the hydrosalpinx is small and the woman does not experience any symptoms, there may be no urgency for surgical removal. However, regular monitoring with ultrasound is necessary to monitor any changes over time.

Dr. Alphy S Puthiyidom
MBBS, MD(Obs&Gn),FMIS(Laparoscopy)
Head of the Department Obstetrics & Gynecology
Advanced Gynecological Laparoscopic Surgeon
& Pelvic Reconstructive Surgeon
Al Garhoud, Dubai
Umm Sequim, Al Barsha South 3, Dubai

Appointments 800-1999