Hydrosalpinx and infertility: what about conservative surgical management?

Chanelles, O.; Ducarme, Guillaume; Sifer, C.; Hugues, Jean‐Noël; Touboul, Cyril; Poncelet, C.

doi:10.1016/j.ejogrb.2011.07.004

Cited by 34 publications

(15 citation statements)

References 25 publications

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“…), and that our respondents are a reasonable cross-section of the SREI and SRS membership. Finally, the present study aimed to describe common practice patterns in the management of hydrosalpinges by reproductive endocrinologists; however, it a recent protocol using laparoscopic neosalpingostomy for management of mild cases of hydrosalpinx merits acknowledgment, because 3% of survey respondents described the use of such an intervention (48). …”

Section: Discussionmentioning

confidence: 99%

How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges

Omurtag

Grindler

Roehl

et al. 2012

Fertility and Sterility

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Objective To describe the management of hydrosalpinges among Society for Reproduction Endocrinology and Infertility (SREI)/Society of Reproductive Surgeons (SRS) members. Design Cross-sectional survey of SREI/SRS members. Setting Academic and private practice–based reproductive medicine physicians. Participant(s) A total of 442 SREI and/or SRS members. Intervention(s) Internet-based survey. Main Outcome Measure(s) To understand how respondents evaluate, define, and manage hydrosalpinges. Result(s) Of 1,070 SREI and SRS members surveyed, 442 responded to all items, for a 41% response rate. Respondents represented both academic and private practice settings, and differences existed in the evaluation and management of hydrosalpinges. More than one-half (57%) perform their own hysterosalpingograms (HSGs), and 54.5% involve radiologists in their interpretation of tubal disease. Most respondents thought that a clinically significant hydrosalpinx on HSG is one that is distally occluded (80.4%) or visible on ultrasound (60%). Approximately one in four respondents remove a unilateral hydrosalpinx before controlled ovarian hyperstimulation (COH)/intrauterine insemination (IUI) and clomiphene citrate (CC)/IUI (29.3% and 22.8%, respectively), and physicians in private practice were more likely to intervene (COH: risk ratio [RR] 1.81, 95% confidence interval [CI] 1.31–2.51; CC: RR 1.98, 95% CI 1.33–2.95). Although laparoscopic salpingectomy was the preferred method of surgical management, nearly one-half responded that hysteroscopic tubal occlusion should have a role as a primary method of intervention. Conclusion(s) SREI/SRS members define a “clinically significant hydrosalpinx” consistently, and actual practice among members reflects American Society for Reproductive Medicine/SRS recommendations, with variation attributed to individual patient needs. Additionally, one in four members intervene before other infertility treatments when there is a unilateral hydrosalpinx present.

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Section: Discussionmentioning

confidence: 99%

How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges

Omurtag

Grindler

Roehl

et al. 2012

Fertility and Sterility

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“…Since it is difficult to directly address these questions during C. trachomatis infection in women, a murine model of C. muridarum infection has been used extensively to study pathogenic mechanisms and immune responses of C. trachomatis (7,8). This is because genital tract infection of mice with C. muridarum can lead to long-lasting hydrosalpinx that closely mimics hydrosalpinx found in C. trachomatis-infected women under laparoscopy (9)(10)(11).…”

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confidence: 99%

Lack of Long-Lasting Hydrosalpinx in A/J Mice Correlates with Rapid but Transient Chlamydial Ascension and Neutrophil Recruitment in the Oviduct following Intravaginal Inoculation with Chlamydia muridarum

et al. 2014

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dLower genital tract infection with Chlamydia trachomatis and C. muridarum can induce long-lasting hydrosalpinx in the upper genital tract of women and female mice, respectively. However, A/J mice were highly resistant to induction of long-lasting hydrosalpinx by C. muridarum. We further compared host inflammatory responses and chlamydial infection courses between the hydrosalpinx-resistant A/J mice and CBA/J mice known to be susceptible to hydrosalpinx induction. Both mouse strains developed robust pyosalpinx during the acute phase followed by hydrosalpinx during the chronic phase. However, the hydrosalpinges disappeared in A/J mice by day 60 after infection, suggesting that some early hydrosalpinges are reversible. Although the overall inflammatory responses were indistinguishable between CBA/J and A/J mice, we found significantly more neutrophils in oviduct lumen of A/J mice on days 7 and 10, which correlated with a rapid but transient oviduct invasion by C. muridarum with a peak infection on day 7. In contrast, CBA/J mice developed a delayed and extensive oviduct infection. These comparisons have revealed an important role of the interactions of oviduct infection with inflammatory responses in chlamydial induction of longlasting hydrosalpinx, suggesting that a rapid but transient invasion of oviduct by chlamydial organisms can prevent the development of the long-lasting hydrosalpinges.

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“…Fair chances of spontaneous conception, as well as more successful IVF-assisted pregnancies, have been reported after a conservative surgical approach as opposed to salpingectomy [11]. Histological examination could help to determine the viability of the tube remnant and resection plane [12].…”

Section: Discussionmentioning

confidence: 99%

Isolated fallopian tube torsion with partial hydrosalpinx in a premenarcheal girl: a case report

2014

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IntroductionIsolated fallopian tube torsion as a complication of a preexisting hydrosalpinx is a rare finding in pediatric patients. The obvious rarity of this condition, its subtle diagnostic features and dissonant previous reporting about the appropriate therapeutic approach according to age, future conception capacity and potential complications of possible pregnancies make the decision about which surgical approach to use very difficult. In this report, we describe the case of a patient with such a presentation and review the literature. Very few similar reports of neosalpingostomy in pediatric patients have been published to date.Case presentationIn our present report, we describe the case of an 11-year-old Caucasian prepubertal girl who presented to our hospital with complaints of abdominal pain in the right lower quadrant, nausea and vomiting. The diagnostic workup led us to conclude that she had a torsion of the right ovary, which was cystically altered. Exploratory surgery revealed a partial hydrosalpinx and consecutive isolated torsion of the fimbrial part. The proximal isthmic part of the fallopian tube was intact and vital. Restorative surgery was performed to create a neosalpingostomy on the viable isthmic part of the tube and remove the cystic and twisted fimbrial and infundibular parts.ConclusionThe surgical procedure described in this report is technically simple and feasible, but leaves doubts about the final outcome.

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Hydrosalpinx and infertility: what about conservative surgical management?

Cited by 34 publications

References 25 publications

How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges

How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges

Lack of Long-Lasting Hydrosalpinx in A/J Mice Correlates with Rapid but Transient Chlamydial Ascension and Neutrophil Recruitment in the Oviduct following Intravaginal Inoculation with Chlamydia muridarum

Isolated fallopian tube torsion with partial hydrosalpinx in a premenarcheal girl: a case report

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