What is the best treatment for hydrosalpinx?

The fallopian tube appears to be a very simple structure, but in real life, many people are troubled by fallopian tube problems. In addition to fallopian tube obstruction, fallopian tube inflammation may also cause some diseases, such as hydrosalpinx. Of course, in most cases, when women suffer from hydrosalpinx, it is mostly related to miscarriage. So, what is the best treatment for hydrosalpinx?

Patients with hydrosalpinx who have no obvious symptoms and no fertility requirements can be observed and followed up without treatment. However, if there is a desire to have children, surgical treatment is the best option. Traditional surgical methods include fallopian tube fimbria-ostomy or fallopian tube fenestration, and pelvic adhesion lysis. With the development of medical technology and the emergence of assisted reproductive technology, fallopian tube root resection has become a better choice for patients with hydrosalpinx.

1. Fallopian tube fimbria ostomy

Salpingostomy is a traditional treatment method suitable for patients with unobstructed proximal fallopian tubes but hydrops and atresia at the distal end.

2. Lysis of fallopian tube and ovarian adhesions

Adhesions of the fallopian tubes and ovaries are very common in patients with infertility and chronic pelvic pain. It is often caused by infection, endometriosis and previous surgery. Usually the attachments are fixed to the posterior leaflet of the broad ligament or to the lateral pelvic wall. The fimbria of the fallopian tube is often encapsulated. In severe cases, the appendages may be wrapped in the rectouterine fossa, making it very easy to damage the intestine during surgery. In this case, the fimbria of the fallopian tube is often normal, but is wrapped by severe adhesions and cannot communicate with the pelvic cavity.

Special care should be taken with adhesions between the ovary and the fallopian tube itself, especially at the fimbria of the fallopian tube. Avoid damage to the ovarian surface and fallopian tube fimbria as much as possible. Otherwise, new adhesions will form after surgery. Therefore, try not to use electrocoagulation or laser. Because it can produce thermal damage and form new adhesions.

3. Fallopian tube root resection

As mentioned above, infertility may be the only reason for patients with hydrosalpinx to seek medical treatment, and the above two surgeries can solve the infertility problem of some patients. However, because the hydrosalpinx and adhesions may recur soon after the operation, the effect is not significant. Repeated examinations or surgeries are not recommended to reduce the chances of infection in patients. With the development of medical technology, the emergence of assisted reproductive technology has provided more and more patients with the opportunity to treat infertility. Infertility due to fallopian tube factors is also an indication for assisted reproduction. If only routine ostomy and adhesiolysis are performed, the hydrops may recur quickly, which will be toxic to the embryo, affect the intrauterine environment, and also affect the development of the endometrium, further affecting the formation and implantation of the embryo and reducing the pregnancy rate. Therefore, patients with hydrosalpinx are most suitable to choose tubal root ligation to completely prevent hydrosalpinx from entering the uterine cavity, and then undergo assisted reproduction. Since the uterus is not damaged, assisted reproductive treatment can be received soon after the operation. However, natural pregnancy is almost impossible with a tubal ligation, so the procedure should only be performed with the patient's fully informed consent.