Hydrosalpinx on ultrasound: research opportunities
Statistics show that every fifth married couple is deprived of the opportunity to become parents. In most cases, the wife can not get pregnant because her fallopian tubes impassable. This problem often occurs after an inflammatory process of hydrosalpinx.
Hydrosalpinx is characterized by failure of tubular obstruction due to accumulation of prosvete liquid pale yellow color. After this pathological process appear adhesions, scarring, which prevents pregnancy. Isolated unilateral and bilateral hydrosalpinx. You can only get pregnant when you lose one tube.
Along with this, many women can not even be aware of the presence of a chronic hydrosalpinx. Typically, acute inflammation manifests itself clinically by pain in the abdomen and fever, which makes you seek medical help.
If time does not diagnose hydrosalpinx, and remove the cause of the obstruction of the fallopian tube, the consequences may be irreversible. In addition, this inflammatory process can lead to ectopic pregnancy. The main methods of diagnosis are: ultrasound, x-ray and laparoscopy.
Ultrasound in detecting tubal pathology
Before going for an ultrasound scan, it is necessary to determine on which day of the cycle it is better to perform. Many experts agree that ultrasound should be done from the fifth–sixth day on the seventh–ninth day (this will depend on the duration of the menstrual cycle). Of course, if necessary, echography can be done in other terms, but in this case it will be obtained less objective data, the ultrasound, and the violation of tubal patency may not be identified.
It should be said that with ultrasound it is impossible to assess the condition of the fallopian tubes out without them (they are only visible after filling them in any contrast agent). You need to add that they can see if they expanded. When hydrosalpinx is detected the expansion of the pipe due to accumulation in the lumen fluid (i.e., liquid is visualized formation located between the uterus and the ovary, with one or two sides).
As you know, after that often develops adhesions that violates the tubal permeability, however, ultrasound can’t detect. It is necessary to conduct hysterosalpingography (an x-ray method).
Hysterosalpingography in assessing tubal patency
Is an x-ray with contrast (oily or water-soluble iodinated agents). The main indication is infertility (the inability to conceive long-term), in most cases, this is caused by impaired patency of the tubes due to hydrosalpinx, endometriosis or other infectious processes (including venereal diseases). Also, this illness can appear after an abortion, undergoing surgery.
X-ray of uterus and tubes with contrast allows to determine the level of violation of their patency. This study is best done starting from the seventh through the fifteenth day of the cycle. You can spend a hysterosalpingography at a later date (twentieth to twenty–fifth day of the menstrual cycle). However, the effectiveness of diagnostic procedures may be reduced, as these days there is a proliferation of epithelium that will prevent the penetration of contrast agents (yodolipola, urografin, ultravista) into the uterine cavity and fallopian tubes after the injection.
Not recommended for x-ray tubes with contrast (hysterosalpingography) before the fifth day of the menstrual cycle, as it is possible to miss a pregnancy.
Along with this, it is believed that after the hysterosalpingography is possible to get pregnant, as the contrast helps to prevent adhesions and scarring in the lumen of the fallopian tubes.
In addition, the x-ray method, there are contraindications:
- allergic reaction to iodine-containing means;
- acute infectious process of the reproductive organs;
- increased pain sensitivity.
Laparoscopy in inflammatory lesions of the fallopian tubes
I should say that this method is crucial in the diagnosis of hydrosalpinx. It is often performed after an ultrasound and x-rays with contrast. Moreover, it can be used not only to diagnose the pathological process, but also to carry out therapeutic manipulation (eliminate the cause, then restore tubal patency).
In most cases, surgical intervention (laparoscopy) is required for tubal obstruction. It should be noted that if the fallopian tube is noted a marked adhesive process, which cannot be corrected, in most cases it is removed.
Surgical intervention is resorted to in cases of ineffectiveness of drug therapy in violation of tubal patency.
To summarize, we can say that hydrosalpinx is a common cause violations of tubal patency and consequently, infertility. For diagnostics of this pathological condition used radiological and endoscopic methods: ultrasound, x-ray and laparoscopy. It is important to determine on what day of cycle is best to make a study.