What to do if you have hydrosalpinx

Problems related to the ovaries are always of great concern to female friends, because as an important part of the female reproductive organs, problems with the ovaries may mean that women have problems with fertility. Hydrosalpinx is a symptom that easily occurs after the fallopian tubes are invaded by various pathogens. Women who suffer from this disease will feel uncomfortable down there. So how should hydrosalpinx be treated?

Hydrosalpinx refers to the swelling of the endometrium, interstitial edema, exudation, and shedding of the tubal mucosal epithelium caused by the infiltration of leukocytes after the fallopian tubes are infected by pathogens. If the acute inflammation of the fallopian tubes is not treated promptly and effectively, pus in the fallopian tube will form.

After the inflammation of pyosalpinx subsides, the pus is gradually absorbed and the fluid in the cavity changes from purulent to serous, which becomes hydrosalpinx. Simple pyosalpingitis may evolve into scar salpingitis or hydrosalpingitis after the inflammation subsides. The latter is a common complication of chronic salpingitis, manifested by occlusion of the fimbria and cystic dilatation of the fallopian tube. The wall of the tube becomes thin and translucent, and the cyst is filled with clear serous fluid. The lumens of the dilated and undilated parts of the fallopian tube are still connected, so patients often have vaginal discharge. The muscular layer of the tube wall atrophies or is completely replaced by fibrous connective tissue, and the epithelium is compressed and becomes cubic or flat. The mucosal folds are reduced, and a small amount of lymphocyte infiltration is present in the lamina propria.

Surgery

Salpingostomy is suitable for patients with unobstructed proximal fallopian tubes but fluid accumulation and atresia at the distal end.

Laparoscopic salpingostomy surgery first fully frees the adhesions between the fallopian tube and other tissues. The fallopian tube is insulated through the cervix to expand the distal atretic fimbria of the fallopian tube, and the fallopian tube is fixed to the fundus of the uterus with non-destructive forceps. Whenever possible, make a cross incision at the original fallopian tube opening using a carbon dioxide laser or microscissors. If the original opening cannot be identified, a "cross" incision can be made in the thinnest avascular area of ​​the fallopian tube wall. Place the grasping forceps into the incision and open and close it several times until the incision is the desired size. The incision should be made towards the ovary as much as possible to facilitate egg collection in the future.

Use atraumatic forceps to grasp the fallopian tube lining at the new incision and turn it outward. In order to keep the incised valve in an everted state and prevent the new incision from adhering again, the serosal surface of the newly incised valve can be treated with a defocused laser or low-power micro-bipolar electrocoagulation. The surface tissue shrinks to achieve the purpose of everting the incision edge. You can also use 4-0 absorbable sutures to directly suture the everted valve to the serosa of the fallopian tube. During the operation, the wound was continuously irrigated with heparin-containing Ringer's lactate solution (5000U/L). After the operation, lactated Ringer's solution, sodium hyaluronate, antibiotics, corticosteroids, antispasmodics and other drugs can be placed in the pelvic cavity to prevent adhesion.

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.