Symptoms of hydrosalpinx vary based on the cause and severity of the disease. It frequently occurs following pelvic inflammatory disease (PID). Patients may present with chronic pelvic pain, lower abdominal pain, low-grade fever, vaginal discharge, and/or non-menstrual uterine bleeding. Other patients will be completely asymptomatic except for infertility [1]. Hydrosalpinx has also been associated with tubal and ovarian malignancy. In such cases a patient may describe a feeling of "fullness" in the pelvic region or an adnexal mass [2]. Hydrosalpinx may be unilateral, however, the fallopian tube on the other side is also abnormal in most of the cases.

• Pain

  Recurrent pelvic pain may signify intermittent noninfarctive torsion, but severe acute pain is a sign of torsion with impending infarction and gangrene in some patients. [pubmed.ncbi.nlm.nih.gov]

  In postmenopausal women presenting with low abdominal pain with an adnexal mass, the gynecologist should contemplate possible torsion of the hydrosalpinx. [ncbi.nlm.nih.gov]

  Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. [hindawi.com]

• Surgical Procedure

  Such cases are good reminders that girls with known abdomino-pelvic anomalies and surgical procedures in childhood need long term follow-up, in particular when entering puberty and maturation. [ncbi.nlm.nih.gov]

  However, as is true of all surgical procedures, even this minimally invasive surgery carries a risk. This surgery can impair ovarian blood flow and reduce ovarian reserve. [drmalpani.com]

  This requires a surgical procedure called neosalpingostomy, in which a laparoscope is surgically inserted into the abdomen and an incision is made to open the blocked fallopian tube. [pacificfertilitycenter.com]

• Swelling

  A hydrosalpinx can grow to several centimeters in diameter, and such swelling would be easy to see on an ultrasound. [hystersisters.com]

  The tube starts getting swelled up, giving rise to a retort shaped swelling, called a hydrosalpinx. The fluid inside may be clear or get infected and turn yellow. It may sometimes be bloody due to small internal bleedings. [buddymd.com]

  It therefore builds up, causing the tube to dilate (or swell). The fluid then gradually migrates into the uterus, where it can prevent implantation of an embryo even if the other tube is completely normal. [txfertility.com]

• Asymptomatic

  Hydrosalpinx are usually asymptomatic and do not require any treatment unless the patient is keen on pregnancy. Table of Contents [melakafertility.com]

  The patient was asymptomatic after the procedure. Torsion of the hydrosalpinx is rare in postmenopausal women. [ncbi.nlm.nih.gov]

  This can cause a previously asymptomatic hydrosalpinx to become newly symptomatic [1]. [gynecolsurg.springeropen.com]

  Hydrosalpinx symptoms Some patients have pelvic or abdominal pain as a symptom; while, others remain asymptomatic. Patients who are asymptomatic and not trying to conceive remain quite unaware of their condition. [aashaayurveda.com]

• Fever

  Patients may present with chronic pelvic pain, lower abdominal pain, low-grade fever, vaginal discharge, and/or non-menstrual uterine bleeding. Other patients will be completely asymptomatic except for infertility. [symptoma.com]

  Risk factors of TOA include younger age, multiple sexual partners, nonuse of barrier contraception, and a history of PID. 1 The clinical manifestations of TOA are similar to PID—lower abdominal pain, fever, chills, and vaginal discharge, with the addition [thepermanentejournal.org]

  She denied any association with food, fever, chills, nausea, and alteration in micturition or bowel habits. She had regular menstrual cycles and no history of sexually transmitted diseases. [hindawi.com]

• Abdominal Pain

  In postmenopausal women presenting with low abdominal pain with an adnexal mass, the gynecologist should contemplate possible torsion of the hydrosalpinx. [ncbi.nlm.nih.gov]

  Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. [hindawi.com]

  After 48 hours, the patient’s symptom of abdominal pain receded. No leukocytosis with a negative CRP was observed. [jmedicalcasereports.biomedcentral.com]

• Nausea

  A 34-year-old woman was admitted for acute pelvic pain with nausea and vomiting. Vaginal examination revealed a right adnexal tender mass and ultrasound revealed a well circumscribed right adnexal cystic mass. [ncbi.nlm.nih.gov]

  She denied any association with food, fever, chills, nausea, and alteration in micturition or bowel habits. She had regular menstrual cycles and no history of sexually transmitted diseases. [hindawi.com]

  After 3 weeks, the patient was readmitted because of abdominal pain, nausea, and vomiting of several hours’ clinical course. She had presented menarche the week prior to readmission. [jmedicalcasereports.biomedcentral.com]

  Women with TOA present with fever and chills (50%), nausea (26%), vaginal discharge (28%), abnormal vaginal bleeding (21%), and acute lower abdominal pain (89%). 2 Women with a presentation consistent with TOA should be evaluated with a complete history [thepermanentejournal.org]

• Constipation

  Chronic constipation and soiling were nevertheless still reported. She was diagnosed with Wilms' tumor of the right kidney at 9 years old. [ajronline.org]

  Other symptoms can include pelvic pressure on the woman’s bladder or rectum, which may result in frequent urination or constipation. Some women will experience pain during sexual intercourse due to an enlarged uterus. [rscbayarea.com]

  In the past, she had a perineal pull-through procedure because of rectovestibular fistula with anal atresia when she was two years of age, and she had sigmoid resection for severe constipation with fecal soiling when she was 11 years old. [caribbean.scielo.org]

• Acute Abdomen

  We managed a middle-aged lady with acute abdomen and after initial tests were inconclusive, we proceeded to diagnostic laparoscopy without much delay and found a twisted right hydrosalpinx. [ijrcog.org]

  When the pipe ruptures, a picture of an acute abdomen occurs, when suppurating the fluid, weakness, intoxication, and an increase in body temperature (pains may be absent, since the sensitivity in the overgrown walls of the tube). [rhazesglobal.com]

  Management Fallopian tube pathologies, including both ovarian cysts and hydrosalpinx, indicate surgical intervention when presenting as an acute abdomen [2]. [gynecolsurg.springeropen.com]

  This case highlights the importance of including PID during the differential diagnosis of acute abdomen in sexually inactive females. Regardless of sexual history, PID should be considered in all women with abdominal pain. [bmcwomenshealth.biomedcentral.com]

• Irritability

  Endometriosis The surgical procedure in itself may sometimes irritate the tube and trigger fibrosis in its distal end. This may block the tube. This swelling is quite big and may be the reason for your symptoms. [buddymd.com]

  It can be caused by any irritant, such as pelvic inflammatory disease (PID), a ruptured appendix, tubal adhesions from a previous surgery or endometrial deposits. [volusonclub.net]

  The irritation and/or adhesions associated with the hydrosalpinx seem to reduce the possibility of conception occurring via the healthy tube. [infertility.about.com]

• Pelvic Pain

  Abstract Isolated torsion of hydrosalpinx is a rare cause of acute pelvic pain. Pre-operative diagnosis is very difficult because of non specific clinical presentation. [ncbi.nlm.nih.gov]

  […] with pelvic pain, infertility or pre-IVF assessments. [volusonclub.net]

• Vaginal Discharge

  […] ovaries after vaginal discharge, and also suggested existence of hydrosalpinx fluid reflux. [ncbi.nlm.nih.gov]

  Patients may present with chronic pelvic pain, lower abdominal pain, low-grade fever, vaginal discharge, and/or non-menstrual uterine bleeding. Other patients will be completely asymptomatic except for infertility. [symptoma.com]

  Women with TOA present with fever and chills (50%), nausea (26%), vaginal discharge (28%), abnormal vaginal bleeding (21%), and acute lower abdominal pain (89%). 2 Women with a presentation consistent with TOA should be evaluated with a complete history [thepermanentejournal.org]

  Excessive vaginal discharge. How is a Hydrosalpinx Diagnosed? HSG : HSG is an X-ray that is used to examine the cavity of the uterus and fallopian tube. [origynivf.com]

• Pelvic Pain in Women

  However, when symptoms are present, the chief complaint is pelvic pain. Some women are unaware of their condition until they seek help for fertility problems. [draliabadi.com]

Workup for hydrosalpinx begins with the patient's medical history, physical exam, and ultrasound imaging. More invasive procedures used to diagnose hydrosalpinx include hysterosalpingography (HSP) and surgical laparoscopy. A history of pelvic inflammatory disease, sexually transmitted disease, endometriosis, infertility, previous lower abdominal or pelvic surgeries, and/or ruptured appendix should be elicited. Hydrosalpinx has been associated with tubal and ovarian malignancy, and therefore questions pertaining to patient or family history of such malignancy and/or recent unexplained weight loss and fatigue may be useful as well. Physical exam includes palpation for any adnexal or pelvic mass. A serum or urine pregnancy test should be administered to any woman of child bearing age to rule out tubal pregnancy.

Transvaginal ultrasonography has a high sensitivity and specificity for diagnosis of hydrosalpinx [2] [3] [4]. Appearance of hydrosalpinx on gray scale ultrasonography consists of an elongated, dilated fallopian tube, with incomplete septations or indentations (commonly referred to as either "waist sign" or "cogwheel"), and anechoic contents [3]. Nodules may or may not be present in the walls; their presence should raise suspicion for ovarian malignancy [5]. Color doppler evaluation can help differentiate hydrosalpinges from ovarian lesions; the former is characterized by flow from the borders and typically high resistance than ovarian flow [6] [4].

Magnetic resonance imaging (MRI) may be used to help identify the nature of the contents of distended fallopian tube [7] [8]. For example, fluid demonstrating a high signal intensity on T1-weighted images is indicative of endometriosis or tubal pregnancy; heterogenous signal intensity in the wall of the tube suggests pylosalpinx resulting from tubo-ovarian abscess; and an enhancing solid mass inside the distended tube is suggestive of tubal carcinoma [9].

Hydrosalpinx is often diagnosed with a HSP. HSP findings demonstrate a dilated, distal fallopian tube showing obstructed fimbria and no spillage of contrast dye into the peritoneum (indicating occlusion) [10].

Laparoscopy allows for confirmatory diagnosis of hydrosalpinx as well as for intervention and treatment such as opening the occluded end of the tube, removal of adhesions, and possible removal of the fallopian tubes in certain cases.

• Chlamydia

  There were no differences in the Chlamydia antigen-positive rate between the HF groups (62.5% vs. 70.6%), and no bacterial growth occurred in the HF specimens. [ncbi.nlm.nih.gov]

  Chlamydia - a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman’s reproductive organs. Other sexually transmitted diseases Having a baby Having an abortion Having an IUD inserted. [womenfitness.net]

• Neisseria Gonorrhoeae

  Although TOA is a complication of PID, Neisseria gonorrhoeae and Chlamydia trachomatis are infrequently isolated from abscess fluid. [thepermanentejournal.org]

  The infection and/or pelvic adhesions (scar tissue) that causes hydrosalpinx can result from any number of factors, including: Gonorrhea - a curable sexually transmitted infection (STI) caused by a bacterium called Neisseria gonorrhoeae. [womenfitness.net]

  Interactions of Neisseria gonorrhoeae with mature human macrophage opacity proteins influence production of proinflammatory cytokines. Infect Immun. 2001 Mar. 69(3):1909-13. [Medline]. [Full Text]. [medscape.com]

Some research finds IVF success rates significantly improve when hydrosalpinx is treated before a treatment cycle. [natural-fertility-info.com]

Ten (12%) units did not recommend treatment of hydrosalpinx prior to IVF treatment, while 30 (36%), 27 (33%) and 16 (19%) recommended treatment weakly, strongly and very strongly respectively. [ncbi.nlm.nih.gov]

There are several treatment options you may try if you have one or more tubes affected by hydrosalpinx. Your doctor should be able to help you determine which type of treatment will best help with your unique case. [healthline.com]

Treatment In order to establish a treatment plan for hydrosalpinx, it is necessary to evaluate its cause, the development time, and if the patient wants to become a mother. [invitra.com]

However, pregnancy rates with IVF exceed the chances for pregnancy with tubal surgery except for the patients with the best prognosis after surgery. [radiologykey.com]

PURPOSE OF REVIEW: Patients with hydrosalpinx are a recognized group with poor prognosis in in-vitro fertilization. This review presents evidence for the effectiveness of different treatment options. [ncbi.nlm.nih.gov]

Therefore, this treatment method is no longer favored, except in a few cases in which the prognosis is high (such as very young patients with mild tubal disease, one sided blockage with no other identifiable pathology and those who cannot afford IVF treatment [laivfclinic.com]

Since, a hydrosalpinx is associated with poor fertility prognosis removing the tube is usually the best option. [inviafertility.com]

Additional recommended knowledge Contents 1 Etiology 2 Symptoms 3 Diagnosis 4 Prevention 5 Management 5.1 IVF and hydrosalpinx 6 History 7 References Etiology While the ciliae of the inner lining (endosalpinx) of the fallopian tube beat towards the uterus [bionity.com]

Torsion of the fallopian tube: some considerations on its etiology. Obstet Gynecol. 1984;64(5):675-8. Rajaram S, Bhaskaran S, Mehta S. Isolated Fallopian tube torsion in adolescents. Case Rep Obstet Gynecol. 2013;2013. Bland-Sutton T. [ijrcog.org]

Etiology of hydrosalpinx includes pelvic inflammatory disease (PID) causing tubal occlusion, previous abdominal surgery, endometriosis, ectopic pregnancy, and congenital malformation. [hindawi.com]

Tubo-ovarian abscess in virginal adolescents: exposure of the underlying etiology. J Pediatr Adolesc Gynecol. 2009;22:e13–6. 5. Moralioğlu S, Ozen IO, Demiroğullari B, Başaklar AC. [bmcwomenshealth.biomedcentral.com]

Study design: The Rochester Epidemiology Project (Rochester, MN) was used to identify three cohorts: women who had undergone tubal sterilization and subsequent hysterectomy, women who had undergone tubal sterilization alone, and women who had undergone [mayoclinic.pure.elsevier.com]

STUDY DESIGN: The Rochester Epidemiology Project (Rochester, MN) was used to identify three cohorts: women who had undergone tubal sterilization and subsequent hysterectomy, women who had undergone tubal sterilization alone, and women who had undergone [ncbi.nlm.nih.gov]

The epidemiology of molar pregnancy and choriocarcinoma. Clin Obstet Gynecol 1984; 27: 153. ‎ Pagina 773 - Pediatr 1989:115:105. 56. Boepple PA. Mansfield MJ. Link K. et al. [books.google.ro]

In fact, a review of epidemiological literature on running injuries — from as early as 1992 —conducted at the University of Amsterdam in the Netherlands, found that 50 to 75 percent of running injuries are caused to the lower extremities by constant repetition [livestrong.com]

The epidemiology of Chlamydia trachomatis within a sexually transmitted diseases core group. J Infect Dis. 1996 Apr. 173(4):950-6. [Medline]. Bjartling C, Osser S, Johnsson A, Persson K. [medscape.com]

The pathology and pathophysiology of hydrosalpinx are reviewed. [ncbi.nlm.nih.gov]

J Postgrad Med 1987;33:34 Despite the fact that vulvovaginitis is by far the most common Candida infection, its basic pathophysiology is incompletely understood. [jpgmonline.com]

Pathophysiology and management of proximal tubal blockage. Fertil Steril. 1999 May;71(5):785-95. doi: 10.1016/s0015-0282(99)00014-x. PMID 10231034. ^ Ducarme, G; Uzan, M; Hugues, J; Cedrindurnerin, I; Poncelet, C (October 2006). [en.wikipedia.org]

The consequence of this tubal pathology is a malfunction of the tubes, which causes infertility by preventing sperm from meeting with the egg for fertilization. [invitra.com]

Tubal infertility is a unique cause for infertility because it usually represents a simple obstruction that prevents sperm and egg from meeting. One specific type of tubal infertility, the hydrosalpinx, is a bit more complicated. [center4fertility.com]

Sclerotherapy uses ultrasound technology to guide a needle to the affected area to drain fluid, and then inject a chemical to prevent any new blockage. [natural-fertility-info.com]

A fallopian tube filled with blood is a hematosalpinx, and with pus a pyosalpinx. http://self.gutenberg.org/articles/Hydrosalpinx http://www.digplanet.com/wiki/Hydrosalpinx#Prevention Associated disease A hydrosalpinx is most commonly associated with [fertilitypedia.org]

Salpingitis symptoms and prevention Salpingitis is the inflammation of the fallopian tubes. [flo.health]

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