HYDROSALPINX AND DISTRIBUTION OF PREGNANCIES AMONG LAPAROSCOPICALLY TREATED PАTIENTS

Abstract

Introduction. Hydrosalpinx is a common medical condition encountered among female population with infertility issues. One or both fallopian tubes can be filled with a substantial amount of fluid, making them dilated and dysfunctional, usually as a result of an injury or infection. Damages of different degrees can be seen on the mucosal lining, which compromise the processes of normal fertilization and zygote passage. Methods. We retrospectively analyzed clinical records from a period of five years (2013-2017), selecting pa- tients diagnosed as having unilateral or bilateral hydrosalpinx. Clinical files were divided by years and according to the treatment protocol used. Our scope of interest was focused on patients who were treated surgically, with different types of laparoscopic interventions. A total of 74 patients met our criteria for selection. Results. Two groups were related to conservative la- paroscopic approaches and one to complete radical surgical treatment, unilateral or bilateral salpingectomy. Patients in the first group, 9(16.36%), were treated with a laparoscopically-guided creation of salpingostomy. The second group comprised patients treated only with bi- lateral chromopertubation and consisted of 17 (30.91%) patients. The third, and the most numerous group com- prised 29(52.7%) patients treated with salpingectomy. Bilateral salpingectomy was performed in 9(31.03%) and unilateral in 20(68.97%) patients, showing that majority of patients were treated with unilateral salpingectomy, after intraoperative evaluation of tubal patency of the contralateral uterine tube. A total number of 30 patients (54.5%) had successful pregnancies, which ended up with a desired outcome, healthy live birth. Procedures for artificial reproduction and successful pregnancies achieved with IVF were recorded in 11(36.67%) patients and in the remaining 19(63.33%) patients pregnancies were achieved via spontaneous conception. Conclusion. Hydrosalpinx management is mainly influenced by the local tubal changes evaluated laparoscopically and can be surgically treated, either conservative or radical. Conservative approaches lead to fair chances of spontaneous conception and successful pregnancies. An integrated management of hydrosalpinx with bilateral salpingectomy and postsurgical usage of artificial reproduction techniques also leads to a substantial cumulative pregnancy rate.