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Hydrosalpinx: Functional Surgery or Salpingectomy

There had been reports about adverse effects associated 6. Marana R, Catalano GF, Muzii L, et al. The prognostic role of
with salpingectomy, especially if performed close to the salpingoscopy in laparoscopic tubal surgery. Hum Reprod
1999;14:2991-95.
uterus as it might disrupt the normal blood flow to the ovary 7. Surrey ES. Micro-endoscopy of the human fallopian tube. J Am
resulting in fewer oocytes being retrieved from the side of Gynecol Laparosc 1999;6:383-89.
the operation during IVF cycles in comparison with intact 8. Vasquez G, Boecks W, Brosens I. Prospective study of tubal
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adnexa. NICE guidelines suggested that the evidence of mucosal lesions and infertility in hydrosalpinges. Hum Reprod
1995;10:1075-78.
impairment of ovarian response in subsequent IVF was 9. Boer-Meisel ME, te Velde ER, Habbema JDF, Kardaun JWPF.
inadequate but emphasize that laparoscopic salpingectomy Predicting the pregnancy outcome in patients treated for
should be done with care not to compromise ovarian blood hydrosalpinx: A prospective study. Fertil Steril 1986;45:23-29.
supply. 35 10. Dechaud H. Hydrosalpinges suitable for salpingectomy before
IVF. Hum Reprod 2000;16(12):2464-65.
Reconstructive tubal surgery should be preferred to 11. Aboulghar MA, Mansour RT, Serour GJ. Controversies in the
salpingectomy in mild forms of tubal disease. 34,36,40,41 modern management of hydrosalpinx. Hum Reprod Update
Preserved tubal mucosa indicates a good prognostic for 1998;4:882-90.
tubal surgery. 34,36 The distinction of hydrosalpinges that 12. Puttemans PJ, Brosens IA. Salpingectomy improves in vitro
ferilization outcome in patients with a hydrosalpinx; blind
can be treated with functional surgery can be achieved by victimization of fallopian tube. Hum Reprod 1996;11:2079-81.
4,5
utilization of tubal endoscopy tests. Therefore, an 13. Coughlan C, Li T C. Surgical management of tubal disease. Obst
appropriate mucosal assessment should be routine prior gynaecol Reprod Med 2008;19(4):98-105.
to deciding upon further management of hydrosalpinges. 11 14. Akande VA, Cahill DJ, Wardle PG, Rutherford AJ, Jenkins JM.
The predictive value of the 'Hull and Rutherford' classification
Fimbrioplasty should be performed in patients with mild for tubal damage. Br J Obstet Gynaecol 2004;111:123-41.
periadnexal adhesions and patent hydrosalpinx mucosa as 15. Ahmad G, Watson AJ, Metwally M. Laparoscopy or
this improves pregnancy outcomes. 35,36 Salpingostomy is laparotomy for distal tubal surgery? A meta-analysis. Hum Fertil
2007;10(1):43-47.
an ideal procedure for mild hydrosalpinges with normal 16. Andersen AN, Meng FJ, Petersen. Low implantation rates after
mucosa as it is associated with better pregnancy rates. 34 IVF in patients with hydrosalpinges diagnosed by
Microsurgical tubocornual anastomosis is the standard ultasonography. Hum Reprod 1994;9:1935-38.
35
treatment for proximal tubal occlusion. This type of 17. Katz E, Akman MA, Damewood MD, Garcia JE. Deleterious
surgery is more effective than no treatment for women effect of the presence of hydrosalpinx on implantation and
pregnancy rates with in vitro fertilization. Fertil Steril
with mild hydrosalpinges and should be considered 1996;66:122-25.
especially in centers where appropriate expertise is 18. Strandell A, Naldenstrom U, Nilsen L, Hamberger L.
available. 35 Hydrosalpinx reduces in vitro fertilization/embryo transfer
pregnancy rate. Hum Reprod 1994;9:861-63.
19. Vandrome J, Chasse E, Lejeline B, et al. Hydrosalpinges in
CONCLUSION
in vitro fertilization; an unfavourable prognostic feature. Hum
Proper assessment of hydrosalpinges tubal mucosa utilizing Reprod 1995;10:576-79.
tubal endoscopy tests should be routine prior to decision 20. Bindirici I, Bukulmez O, Ensari A, Yarali H, and Gurgan T.
A prospective evaluation of the effect of salpingectomy on
about the choice of surgical treatment as this will prevent endometrial receptivity in cases of women with communicating
mis-management of patients. hydrosalpinges. Hum Reprod 2001;16(11):2422-26.
21. Mukherjee T, Copperman AB, McCaffrey C, et al. Hydrosalpinx
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