gidrosalpinksa - it is one or two-sided hydrocele fallopian tube, formed after the inflammatory process.Hydrosalpinx is a sac filled with serous fluid, and is a complication of acute salpingitis.
Fallopian tubes are the uterus, due that implement the reproductive function of the female body.In appearance, each fallopian tube is like a hollow thin tube length of 11 cm, it starts at the upper corner of the uterus (uterine end) and opens into the abdominal cavity near the ovary, where it forms an extension - a vial (ampullar end).The wall of the fallopian tube is formed by three layers:
- serous dense outer layer protects the pipe from negative influences;
- Elastic middle muscular layer formed by muscle fibers that are capable of peristaltic movements directed towards the uterus;
- mucous layer lining the inner cavity of the fallopian tube, it forms many longitudinal folds and is coated with the cells of the ciliated epithelium.These cells have on their surfaces a special
oocyte maturation occurs on the surface of the ovary.In the interior of the outer (tunica) shell of the ovary are many follicles, each of them is present at various stages of oocyte maturation.The maturation of the follicle and the egg is symmetrical, so when a mature follicle bursts, it releases mature, ready to fertilize the egg (ovulation).Then the egg falls into the abdominal cavity.Its viability is maintained for two days, and then it dies.In the case of fertilization, the egg enters the fallopian tube and into the uterus moves through reduced muscle sheath tube flicker epithelial layer, as well as tubular glands that moisturize the surface epithelium and facilitate the process of movement.
avilable fallopian tubes are connected with the need to promote a fertilized egg from the uterus into the abdominal cavity for subsequent implantation (introduction) and the development of pregnancy.That is why the peristalsis of the fallopian tubes is enhanced in the period coinciding with the time of ovulation and subsequent, luteal, phase of the cycle.
Fallopian tubes are richly developed network of blood vessels through which the inflammatory processes in this field are developing rapidly and quickly spread to the surrounding tissues in the absence of good local immunity.Isolated inflammation of the fallopian tubes (salpingitis) is much rarer combined inflammation in the tubes and ovaries (salpingo).
hydrosalpinx formation process begins after an episode of acute inflammation of the uterine tube, acute salpingitis, and is its complications.Inflammatory effusion (exudate) accumulates in the uterine tube, it sticks together and forms a wall of a closed liquid education.
hydrosalpinx is a mechanical obstacle to the egg in the uterine cavity and is the cause of tubal infertility.When a unilateral process in women is one healthy fallopian tube and has a chance to get pregnant, and double-sided hydrosalpinx making pregnancy impossible.
often infertility when hydrosalpinx is the only reason for referral to a specialist.The clinical picture when hydrosalpinx is similar to that in chronic inflammatory diseases of the uterus.The most striking clinical picture hydrosalpinx develops on the background of pronounced adhesions in the pelvic area.
Drug gidrosalpinksa removal and elimination of its consequences is impossible.Gidrosalpinksa Therapy involves a two-stage sequential elimination of the pathological process in the fallopian tubes.First conducted an adequate anti-inflammatory treatment, and then hydrosalpinx is removed surgically.Preference is given to laparoscopic techniques for the elimination of the pathological education.The success of treatment is determined not by the quality of performing a surgical procedure, and the ability to recover the due function of the fallopian tube.
Unfortunately insidious disease is that even with the successful elimination of hydrosalpinx and the full restoration of the Fallopian tubes, the woman is often fruitless.Very often such a situation arises in patients with long-term chronic inflammation of the uterus and appendages in the expression of adhesions in the abdominal cavity.
Modern women want to have as much information about their health and modern medical techniques.Using the correct terms to quickly find the necessary information in all available sources.Sometimes patients use the wrong terms in the title of his illness.Misused phrase hydrosalpinx pipes to find the information you need."Sea" means a liquid, and "salpinks" - tube, which means that gidosalpinks tube does not exist.
A similar situation occurs with the title surveys.Speaking laparoscopy gidrosalpinksa wrong.Laparoscopy - is instrumental methods of examination of internal organs, allowing to see the abdominal or pelvic cavity inside.In addition to the fallopian tubes doctor sees all the surrounding organs and tissues.Instead laparoscopy laparoscopy gidrosalpinksa correct to say when hydrosalpinx.
The formation of hydrosalpinx associated with occlusion of the fallopian tube ampullar department if there is a local infectious-inflammatory process.
gidrosalpinksa formed after suffering acute nonspecific inflammation in the fallopian tube (salpingitis).The source of the inflammation may be pathogens and representatives of conditionally pathogenic microflora.Usually, the cause of acute salpingitis is not the only micro-organism, and their association, as part of which may be streptococci, staphylococci, Chlamydia, Mycoplasma, E. coli and others.
Sources of infection often rise into the cavity of the tube located below the divisions: the vagina, cervix or uterus.Options downward spread of infection are rare, in this case, the infection of the fallopian tube occurs by hematogenous (through the blood) due to the presence of infections in distant organs: kidneys, bladder, tonsils, intestines and others.
cause of inflammation of the fallopian tubes are:
- Infectious-inflammatory diseases of the uterus (endometritis).
- promiscuous.In addition to the likelihood of ill sexually transmitted diseases, it helps to change the composition of the normal vaginal microenvironment.When undesirable microorganisms becomes too much, they cause inflammation.
- Frequent exposure to cold, depleting the body's defenses.
- Abortion, diagnostic manipulation and birth defects of the genitals.The infection enters the genitals through an extensive wound surface.
- Intrauterine contraception.The introduction of the uterine spiral may be accompanied by the emergence of hotbeds of local non-infectious inflammation of the endometrium, under unfavorable conditions on its background may develop infectious process.It is also an infection in the uterus from the vagina can rise on the uterine spiral filaments.
- Infectious and inflammatory lesions of the cervix: cervicitis and endocervicitis.
- Long-existing inflammation of the vagina significantly alter the composition of normal microflora and deplete the immune defense mechanisms of the mucous infection.Excessively multiplied pathogenic microflora may eventually become a source of inflammation in the cervical canal, then climb into the fallopian tubes.
predispose to infection of the fallopian tubes factors are: neglect of the rules of personal hygiene, stress and fatigue, disbiotic violations in the vagina.
Endocrine and hormonal diseases exacerbated for salpingitis.Diabetes and thyroid disorders reduce the ability of the body to resist infection.
contribute to the process of formation of hydrosalpinx and physiological defense mechanisms.When inflammation occurs in the fallopian tube body seeks to isolate it from the surrounding tissue to prevent further infection of the pelvic cavity of the uterus or in the case of descending infection.Therefore ampullar Front pipe quickly "closed" with the subsequent formation of hydrosalpinx.
episode of acute infectious inflammation of the fallopian tube is not always ends with the formation of hydrosalpinx.With good immunity and timely treatment of the adverse effects do not develop.
Symptoms and signs gidrosalpinksa
Regardless of the type of infection and the mechanism of its penetration into the fallopian tube, all kinds of infection affect its ampullar department.
If you get an infection in the fallopian tube begins to develop local inflammatory process.Pipe wall thickens due to pronounced edema, deforming its cavity.Inflammation causes cancer of the fallopian tube to work hard, produces a lot of inflammatory fluid (exudates).With the accumulation of exudate and increase pipe and increases pressure on the surface ciliary epithelium is damaged as a result it becomes unviable, and the proportion of ciliated secretory cells and is shifted upward past.As a result, ciliated epithelium at the site of inflammation atrophy.With increasing signs of local inflammation exudate produced more and more, it becomes thicker and sticky.In places the death of ciliated epithelium occurs sticking to the walls of the tube scarring - adhesions.The spaces between the spikes similar to the cell which accumulates in the inflammatory fluid.As a result, pronounced adhesions occur gross anatomical changes in the tube: the tube "sealed" and turns into a saccular inflammatory education psevdoopuholevoe - hydrosalpinx.
hydrosalpinx When a simple form of a closed tube has an enlarged cavity filled with liquid contents.If the lumen of the tube adhesions divided by partitions into separate cavities, called follicular hydrosalpinx.
external manifestation of both varieties are identical gidrosalpinksa: pipe due to the existing plot thickened like a retort, its wall due to hyperextension looks so thin that through it you can see clear, bright and clean liquid.Often diagnosed sided hydrosalpinx not always symmetrical structure, ie the right hydrosalpinx can be simple and to the left hydrosalpinx may have follicular structure, and vice versa.
gidrosalpinksa Sometimes the contents poured out of the tube.If inflammatory fluid breaks through the abdominal opening of the tube into the pelvic cavity, it provokes an inflammatory response feedback.In the case of the evacuation of fluid into the uterus through the fallopian tube opening, the patient there are abundant watery discharge and unilateral pain cramping in nature.This phenomenon is called hydrosalpinx ventilated.
Inflammatory processes in the fallopian tubes does not occur in all patients the same.If you get an infection in the tube inflammatory exudate accumulates not always.Many patients with acute salpingitis formed a small amount of inflammatory fluid simply dissolves, and only a small proportion of patients the inflammation spreads throughout the pipe, followed by the formation of hydrosalpinx.
clinical picture in hydrosalpinx determined disease that it provoked.Most often hydrosalpinx formed after acute salpingitis, when the disease becomes chronic, and is accompanied by symptoms of chronic inflammation: not intensive abdominal (often on the affected side), menstrual irregularities, abnormal discharge, as well as infertility.
If hydrosalpinx accompanied by adhesions in the surrounding tissues, patients experience severe pelvic pain without clear localization.Clinical disease is sometimes similar to the surgical pathology, so the right hydrosalpinx can be confused with appendicitis, but the left hydrosalpinx has features of left-sided kidney or intestinal colic.
Most gidrosalpinksa diagnosed when examining patients with infertility.If the patient has a healthy tube pregnancy may then existing hydrosalpinx during pregnancy indicates the presence of infection and requires observation and to eliminate it can be after the birth.In the case of aggravation of chronic salpingitis hydrosalpinx during pregnancy has symptoms similar to those in non-pregnant.
leading role in the diagnosis of hydrosalpinx belongs to instrumental methods of examination.Ultrasound hydrosalpinx is defined as a thin-walled formation of irregular hypoechoic or anechoic filled contents.From cyst his own distinguished presence of a thick capsule.The cavity can detect hydrosalpinx walls and the pipe itself during the inflammatory process looks thickened and deformed.However, ultrasound is not always able to reliably determine the nature of the pathological changes in the fallopian tubes, particularly if gidosalpinksa small size and its contents badly rendered.
more informative method of diagnostics of anatomical abnormalities in the tubes of the uterus is salpingography in which the uterus and fallopian tubes injected contrast fluid, and then carried out X-ray examination.Contrast fills the cavity of the fallopian tubes and reveals all the inside defects.With this survey we can determine how much fallopian tube is passable, and to assess the chances of the patient's pregnancy.Typically, if administered contrast appears in the pelvic cavity, this means that he was able to pass through the tube that is - uterine tube is passable.In the case of pipe blockage, contrast accumulates in ampullar department.
Unlike all other methods of diagnosing hydrosalpinx, absolute confidence in the diagnosis can only provide diagnostic laparoscopy.In that case, if you want to delete and restore hydrosalpinx tubal patency, laparoscopy becomes therapeutic and diagnostic procedures.
hydrosalpinx hydrosalpinx treatment without surgery is almost impossible.The treatment program includes two phases.
The first step is:
- to establish the source of infection and to determine the appropriate antimicrobial to eliminate it.
- to determine the nature of structural defects in the affected pipe (one or both);
- find out how far spread the inflammatory process, if there is evidence of inflammation in the ovaries or pelvic cavity;
- identify related infectious and inflammatory changes in the vagina, uterus and cervix;
- dishormonal available to diagnose the disorder.
complex therapeutic measures in the first phase of therapy gidrosalpinksa includes antibacterial, anti-inflammatory therapy and physiotherapy.Most often, the first phase is a preparatory treatment, and after the surgery is performed to remove the hydrosalpinx laparoscopically.
Sometimes patients try about treatment without surgery gidrosalpinksa yourself using randomly selected antibacterial agents, or use the recipes of traditional medicine.This practice does not bring the proper use or leads to an imaginary recovery when symptoms persist, a chronic process continues to progress, and can lead to rupture of the fallopian tube.