HYDROSALFENKS
HİDROSALFENKS (TO HAVE WATER BAGS IN TUBE)
It is the occlusion of the tubes and their becoming liquid-filled cystic due to a previous inflammatory condition. It can be unilateral or double sided.
The presence of hydrosalfenx reduces pregnancy rates in IVF by 30%, therefore hydrosalfenx should be intervened before the IVF procedure.
Laparoscopy is performed on the patient with hydrosalfenxia, the tubes are directly observed. If the mucosa of the tubes is healthy, first of all, the enlarged tubes are corrected surgically and an open tube is tried to be created (salphingostomy operation). If open healthy tubes are formed, the patient is given a certain period of time, as the patient may have a chance to conceive naturally.
If the damage in the tubes is too great to be corrected, the tubes on both sides are removed (salfengectomy) and the patient is prepared for IVF.
In some cases, it may not be possible to remove the tubes due to adhesions or because removal of the tubes may disrupt the feeding of the ovaries, the connection between the hydrosalfenx and the uterine cavity is cut by burning the tube removal site on both sides (tubal ligation is performed).
Hydrosalfenx can also be aspirated vaginally under ultrasound guidance, but it is likely to recur after the intervention in this way and is not a preferred method due to the high risk of infection. In cases where the woman's age is advanced, aspiration can be performed in order not to waste time with surgery, or in such cases, IVF treatment can be started without doing anything. Again in older women, in order not to waste time, IVF can be performed first, and the quality embryos obtained are frozen, and frozen embryo transfer can be performed after salfengectomy surgery.
In patients with unilateral hydrosalfenxia, if the other tube is healthy and there is no other problem, the probability of spontaneous conception after unilateral selfingectomy is high.
USG image of hydrosalfenx
Laparoscopic salfenjectimia (removal of hydrosalfenx by laparoscopy)
