There are two primary options for treating hydrosalpinx: salpingectomy and proximal tubal occlusion. However, sclerotherapy may be an effective alternative to these surgical procedures. Although the American Society for Reproductive Medicine recommends surgery for hydrosalpinx, a sclerotherapy treatment may be a viable option for patients. A review of the available treatments will help doctors decide whether sclerotherapy is a viable alternative.
Interventional ultrasound sclerotherapy
The effectiveness of interventional ultrasound sclerotherapy for watery hydrosalpinx remains to be seen. The process involves insertion of an aspiration needle into the hydrosalpinx, followed by suction. In some cases, the procedure may improve the chances of successful in vitro fertilization and embryo transfer. The procedure is safe and has shown no significant adverse effects on perinatal outcomes.
Of the 41 women who underwent salpingectomy, 12 underwent sclerotherapy, and 29 underwent salpingectomy. A significant proportion of patients in the sclerotherapy group had previous surgeries, including multiple operations. Although the rates of live birth and embryo implantation were similar in group A, B, and C, the researchers noted that four of the women in group C had recurrent hydrosalpinx, and that five required repeated sclerotherapy.
A microinsert needle, measuring 2mm in diameter in expanded form, is inserted into the hydrosalpinx. Once the aspiration needle is fully inserted, 98% ethanol is infused into the fallopian tube, and the patient is monitored for an hour. Patients are then prescribed antibiotics to treat any bacterial infections that may have developed. Afterward, the fluid-filled tube will have no visible fluid in it. The remaining fluid will be at a tenth of its original size.
Hydrosalpinx can also interfere with fertility and can make it difficult to conceive a baby. Around 30 percent of all females have this condition. While pregnancy rates are high with a normal fallopian tube, the chances of conception are lower if the blocked tube is obstructed. The results will vary depending on the cause and severity of the blockage.
The procedure involves making small incisions in the abdomen. A camera is then inserted to visualize the reproductive organs. It is also possible for the fluid and inflammatory immune cells to be brought to the area of the tube closure. However, the treatment is not without risk and requires a second surgery, which may be necessary. It is best suited for women who are considering surgery for hydrosalpinx.
Laparoscopic sclerotherapy
In vitro fertilization is a treatment for infertility that uses eggs taken from a woman’s ovaries. The eggs are then fertilized and implanted in the uterus to conceive. It’s a successful and painless procedure, but the procedure comes with its risks. Several complications can arise before the blockage is removed. Fluid from the tube can make implantation difficult, increasing the risk of miscarriage.
The procedure aims to prevent recurrence of the problem. During the procedure, the physician makes several small incisions in the abdomen and inserts a camera. With this equipment, the surgeon can view and operate on reproductive organs, including the fallopian tube, as well as the surrounding tissue. Using a laparoscope, the surgeon can diagnose other problems that are causing infertility. For example, hydrosalpinx can block the fallopian tube, preventing an egg from being able to pass through. Other symptoms may include pelvic pain or unusual vaginal discharge.
In the study, the procedure is performed with the aid of ultrasound guidance. Patients are randomly assigned to one of the three groups: group A or group B. In group C, the procedure was performed on women with a hydrosalpinx of varying severities. During the procedure, the doctor uses an ovum aspiration needle to remove fluid from the fallopian tube. The needle is then inserted under ultrasound guidance and suction is applied until no more fluid is visible. After the procedure, patients are observed for up to one hour and are given oral antibiotics for three days. The patient can also undergo repeated sclerotherapy.
The procedure can cause discomfort if the alcohol leaks into the abdomen. This will eventually be resolved through drainage of the alcohol from the abdominal cavity. Fortunately, this type of treatment does not require surgery or hospitalization. The procedure can be performed quickly and successfully in some cases. The best way to determine whether a treatment will work for you is to consult with a doctor. You can also learn about the risks and benefits of interventional ultrasound sclerotherapy in patients with hydrosalpinx.
Percutaneous ethanol injection
The process of conceiving is complicated and difficult when the fallopian tubes become blocked with fluid. This blockage hinders the egg’s journey to the uterus, where it meets the sperm and carries it to a developing fetus. While hydrosalpinx can be treated successfully, it can also increase the risk of pregnancy because a blocked fallopian tube can prevent an egg from reaching the uterus.
A sclerosant of 96% ethanol is used to treat the disease. The procedure is done under general anesthesia and requires a minimum of nine therapeutic sessions. The follow-up period is at least one year, and imaging studies can be performed if clinically indicated. A total of 17 patients experienced complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients, however, remained symptomatic after the procedure and were considered failures. However, five patients experienced complications ranging from pulmonary embolus to skin ulcers and blisters. All were successfully treated and have recovered.
The procedure is not permanent and can be used to treat other medical conditions, including tubal pathology. While most women suffering from hydrosalpinx don’t notice symptoms, some may experience pelvic pain or lower abdominal discomfort, or a discolored discharge. In rare cases, women may even experience ectopic pregnancy. In either case, the treatment will help them navigate their fertility journey and achieve a child.
One study compared 99% ethanol with 50% acetic acid in patients with simple renal cysts. It included 64 patients with cysts and evaluated the results using CT and ultrasound imaging. The treatment was performed in the same manner for 32 patients with 99% ethanol and 40 patients with 50% acetic acid. The results were analyzed using ultrasonography and CT, and the underlying medical records were reviewed to assess complications.
In addition to the percutaneous application of ethanol, a sclerosing agent may also be used. An ethanol-gel sclerotherapy may help reduce systemic effects and increase local effects. The procedure is effective in cases where the treatment has failed with compression garments. A new study shows that ethanol-gel sclerotherapy reduces the pain and swelling associated with hydrosalpinx.
Results of sclerotherapy
If you’re concerned about your ability to conceive, you may want to consider sclerotherapy for hydrosaline blockages. While this procedure is not a cure for the condition, it is an effective alternative to salpingectomy. While sclerotherapy can reduce the risk of implantation, you should consult a doctor to determine whether the procedure is right for you.
The results of this study were reported in three ways. The first was the absence of hydrosalpinx in all three patients. This was followed by a reduction in hydrosalpinx in the remaining three patients. The second treatment method, ultrasound-guided aspiration, had no significant effect on hydrosalpinx. However, the results were mixed. While one patient did not improve significantly, three others had their hydrosalpinx disappear completely.
In this study, 12 out of 41 hydrosalpinx patients underwent previous surgery. Of the 29 patients who underwent sclerotherapy, only four had previously undergone salpingectomy. In contrast, thirty-six patients underwent salpingectomy, which requires general anesthesia and hospitalization. The surgery may reduce blood flow to the ovaries and may reduce the pregnancy rate. If you’re suffering from persistent hydrosalpinx, ultrasound-guided sclerotherapy may be a better option.
In some cases, a woman may experience a recurrence of hydrosalpinx despite undergoing sclerotherapy. In such cases, fertility specialists may recommend surgery instead. The surgery, which involves cutting open the affected tube, opens the blocked portion while leaving the rest of the fallopian tube intact. If this method fails to cure hydrosalpinx, however, the patient will experience a recurrence of hydrosalpinx.
A procedure called laparoscopy may be the next option. During the procedure, a thin, lighted instrument with a small camera is inserted through an incision in the belly button. The laparoscope enables the doctor to see the fallopian tubes on a screen. Laparoscopy may also be used to confirm an earlier diagnosis of hydrosalpinx. This procedure is invasive, requiring general anesthesia.
Several studies have evaluated the efficacy of salpingectomy compared to ultrasound guided aspiration in patients with hydrosalpinx. A small retrospective study by Na et al. concluded that salpingectomy was not more effective than ultrasound-guided aspiration in patients with hydrosalpinx. However, one small study conducted on a smaller number of patients suggested that salpingectomy could significantly improve the patient’s chance of getting pregnant.