Is surgery necessary for hydrosalpinx?

Hydrosalpinx is a very common gynecological disease, which mainly occurs when the fallopian tubes are infected. Childbirth, miscarriage, and unclean sexual intercourse may all cause hydrosalpinx. The fallopian tube is a very important reproductive organ in women, and surgery is often used in its treatment. So, does hydrosalpinx require surgery? Let’s take a look below.

Whether hydrosalpinx requires surgery depends first on the size of the fluid. If the effusion is relatively small, then you can try to use blood-activating and blood-stasis-removing drugs for treatment first. Because surgery is very damaging, there is no need for it if medication can cure hydrosalpinx. If the area of ​​fluid accumulation is large and has affected the output of eggs or even caused women to be infertile, then surgery is needed in a timely manner. There are 2 types of surgery for hydrosalpinx:

Traditional surgery involves making an abdominal incision to remove the fluid accumulated in the fallopian tube, then administering bactericidal and anti-inflammatory drugs, and finally suturing the incision. The entire fallopian tube hydrops surgery process is then completed. Traditional surgery is relatively more effective than drug treatment for hydrosalpinx. However, due to the large area of ​​the incision, it is easy to cause surgical accidents such as heavy bleeding in women, so it is best not to have surgery in a small hospital.

Minimally invasive surgery for hydrosalpinx is mainly laparoscopic surgery. The advantage of this type of surgery is that it causes a relatively small area of ​​trauma and has high precision, and can accurately remove the fluid accumulation area. Also, because the trauma area is small and the speed of fluid drainage is relatively fast, the pain women suffer when undergoing fallopian tube hydrops surgery will be reduced.

Nonsurgical treatment

Get adequate rest, reduce sexual intercourse, and thoroughly treat cervicitis, inflammation of the vulva, vagina, and urethral glands, especially cervical erosion, which can cause repeated infection of the appendages and the possibility of acute attacks. In addition, the following methods are available:

1. Antibiotic treatment should be applied locally, and lateral fornix closure or intrauterine injection can be used:

(1) Antibiotic lateral fornix occlusion: once a day or every other day depending on the condition, 7 to 8 times as a course of treatment. If necessary, the injection can be repeated after the next menstruation. Generally, 3 to 4 courses of treatment are required. Dexamethasone or prednisolone can also be added and injected simultaneously.

(2) Intrauterine injection of antibiotics into the fallopian tube: The operation is the same as the method of tubal insufflation, or a double-lumen rubber catheter is inserted into the uterine cavity. The injection volume is gradually increased according to the size of the uterine cavity and the degree of fallopian tube occlusion. The initial dosage should not exceed 10 ml, and the injection solution should not be lower than room temperature to avoid causing fallopian tube spasm. The pressure should be less than 21.3 kPa and injected slowly at a rate of 1 ml per minute. After injecting the medicine, maintain the cycle for 15 to 20 minutes, remove the rubber tube, and ask the patient to lie still for half an hour. Start every month 3 to 4 days after the menstrual blood stops, once every 2 to 3 days, 5 to 6 times as a course of treatment, for a total of 3 to 4 courses.

In addition to penicillin and gentamicin, the drug should also contain hyaluronidase, chymotrypsin or dexamethasone. Hyaluronidase can hydrolyze hyaluronic acid in tissues to accelerate the penetration and absorption of the drug and increase its efficacy. Chymotrypsin can dissolve fibrin and remove necrotic tissue, hematoma and other secretions.

Adrenal cortex hormones are often used in combination with antibiotics to treat chronic salpingitis. It is reported that simply injecting antibiotics into the fallopian tube cavity can make obstruction unobstructed in 10% of cases, while adding dexamethasone can make the rate reach more than 50%. Most patients take two cycles of prednisone before the injection, that is, take 20 mg/d of prednisone for 5 days starting from the fifth day of each cycle, gradually reducing to 15 mg/d for 5 days, 10 mg/d for 10 days, a total of 20 days. Intrauterine injection is performed after the menstruation in the third cycle. The first three times use 800,000 u of penicillin, 160,000 u of gentamicin, and 1500 u of hyaluronidase (or 5 mg of α-chymotrypsin) dissolved in 10 ml of normal saline. For the next three times, use 5 mg of dexamethasone plus antibiotics. After two courses of treatment, rest for one month and repeat the injection until the tube is unobstructed.

2. Physical therapy: It can promote blood circulation and help dissipate inflammation. Commonly used methods include ultrashort wave, diathermy, infrared irradiation, etc.