Effects of hydrosalpinx on endometrial implantation failures: evaluating salpingectomy in women undergoing in vitro fertilization / Efeitos do hydrosalpinx no falho de implantação endometrial: Avaliar a salpingectomia nas mulheres em curso de fertilização in vitro

Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

Assessment of Etiological Factors of Female Primary Infertility

Aims: The aim of the study was to assess the etiological factors of female primary infertility.Place and Duration of the Study:This prospective study was conducted in the Gynaecology clinic of Sree Balaji Medical College and Hospital, Chennai, from August 2016 to February 2018.Methods:All the reproductive age group women coming to Gynaecology opd out patient clinic with historyof anxious to conceive. Those patients who satisfy the above criteria those have been selected for the study.The test has been carried out in hospitalized patients:1.A detailed history were taken.2.General physical and systemic examination were done.3.Ovarian factors and uterine factors ruled out.4.For tubal cannulation.The data collection technique adopted in this technique is structured questionnaire on the evaluation of infertility in couple of less than 35 years of age in a period of infertility less than 5 years from infertility OPD for one and half years of Sree Balaji Medical College and Hospital. Detailed history obtained from the couple and evaluate, informat ion with the help of various investigation in evaluating an infertile couple[1].Results:Age: The prevalence of infertility in the age group 21 –29 years were about 76% in women. Menarche This showed that maximum number of female attain menarche at the age group of 12 to 14years. In our study, it is observed that there is a strong relationof infertility with BMI, the prevalence of infertility increases as BMI Increases in population. 22% of the women have BMI above 30 (obese).In our study, 8% of the women has hydrosalpinx, 4%of the women had fibroids and 6% of the women has polyps. We observed that 4% of the women had unilateral fallopian tubal block and 2% had bilateral fallopian tubal block [2].Conclusion:In modern era of economically growing world we have concluded that the prevalence of infertility is about 76% in women age group of21-29, 40% of the women has attained menarche at 12-14 years, observed hydrosalpinx in 8%, polyps in 6% and fibroids in 4% [3].

Hysterosalpingogram in evaluation of primary and secondary infertility: a two year study at a tertiary care hospital of South India

Background: Infertility globally is a raising threat and problem associated with significant social and psychological problem. Infertility currently affects about 10 to 14 percent of the Indian population, with higher rates in urban areas where one out of six couples is impacted. Patency of the tubes, structure of uterus and cervix can be visualized by hysterosalpingogram which is a simple safer inexpensive investigation of choice in cases of infertility. Objective of this study was to study the role of hysterosalpingography (HSG) in cases of primary and secondary infertility and to observe the structural abnormalities of cervix, uterus and fallopian tubes.Methods: A two year prospective study was conducted on cases of primary and secondary infertility attending the OPD of infertility clinic. HSG was performed on the subjects included in study and findings were noted. Analysis was done by Microsoft excel spread sheet.Results: A total of 286 cases with 11.19% of primary infertility and 88.81% of secondary infertility evaluated by HSG. Mean age of the study group was 35.16±2.8 years. 74.83% had abnormal findings, with 20.28% having normal uterine cavity with uterine filling defect being the common abnormality. Two congenital anomalies of uterus were noted. Tubal occlusion was seen in 8.39% right and 9.09% left cases. Hydrosalpinx was observed in 7.69% of right and 9.79% of left cases.Conclusions: To conclude, women presenting with infertility should be evaluated for tubal pathology. The tubal pathologies like occlusion or hydrosalpinx may be due to infections or post surgical sequelae. HSG remains one of the diagnostic backbone in infertility even availability of new modalities.

Relationship between fallopian tube abnormality and repeated failure of IVF / 中国实用妇科与产科杂志

Repeated IVF failure has been a pain pointin the assisted reproductive process.The fallopian tubehas long been considered as a conduit for transporta-tion,ignoring its important role in embryo implantation.The main reasons for the repeated failure of IVF areembryonic factors,endometrial receptivity and otherfactors.The article mainly focuses on the effects ofvarious types of fallopian tube lesions on the abovethree factors,and analyzes the relationship betweenvarious oviduct chronic inflammatory lesions and IVFfailure.IVFfallopian tube obstructionendome-

Key factor analysis of the treatment for severe distal tubal diseases / 中国实用妇科与产科杂志

Severe tubal disease remains an importantfactor in female infertility.The fertility outcomes forpatients with tubal disease with hydrosalpinx is re-duced by half compared with patients without hydro-salpinx.Neosalpingostomy can improve pregnancy ratessince it eliminates retrograde flow of the hydrosalpingxfluid into the cavity while offering the potential forspontaneous conception.The efficacy of the restorativesurgery is related to tubal damage and the skills of thesurgeon.This study is to demonstrate step-by-step thetechnique of laparoscopic neosalpingostomy,aiming to help increase the fertility rate as well as lower the riskof recurrence.

Effect of different laparoscopic methods on IVF-ET reproductive outcomes and ovarian reserve function in the treatment of hydrosalpinx / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the effect of laparoscopic treatment for bilateral hydrosalpinx on ovarian reserve function and IVF-ET(in vitro fertilization and embryo transfer,IVF-ET)outcomes.METHODS: A retrospective analysis was performed in 84 patients with bilateral hydrosalpinx admitted to Shengjing Hospital Affiliated to China Medical University from January 2015 to January 2017.Group A underwent bilateral salpingectomy(21 cases)and group B underwent laparoscopic bilateral tubal proximal ligation distal ostomy(63 cases);group B1 included cases of tubal interstitial tubal ligation and distal ostomy(28 cases)and group B2 included cases of fallopian tube tubal ligation and distal ostomy(35 tubal ligation cases).RESULTS: There was no significant difference in anti-Mullerian hormone(AMH),follicle stimulating hormone(FSH),estradiol(E2),or FSH/luteinizing hormone(LH)levels between groups A and B(P>0.05),but the LH level of group A was higher than that of group B[(5.44±2.93)U/L vs.(3.20±1.40)U/L];this difference was statistically significant(P0.05).There was no significant difference in reproductive outcomes between groups B1 and B2(P>0.05).CONCLUSION: Compared with tubal ligation,salpingectomy can reduce ovarian reserve function to a certain extent;there is no significant difference in IVF-ET outcomes after tubal ligation at different locations.

Retrospective comparative analysis of transumbilical laparoendoscopic single site and conventional multi-incision laparoscopic bilateral tubal ligation and their prognosis of in vitro fertilization and embryo transfer / 实用医学杂志

Objective To compare the parameters of bilateral tubal ligation by LESS and multi-incision laparoscopy and their prognosis of IVF-ET. Methods From Jun. 2016 to Dec. 2017,32 patients underwent LESS bilateral tubal ligation and 60 patients under-went multi-incision laparoscopic bilateral tubal ligation were enrolled. The demographic data ,operative parameters ,and postoperative prognosis of IVF- ET in the two groups were summarized and compared. Results The mean operating time in LESS group was prolonged and its operative hospital stay was significantly decreased compared to multi-incision laparoscopic group. No significant difference was observed in the intraoperative blood loss in two groups. Moreover,no significant differences were found in the AFC,AMH,Gn stimulation days,total Gn dosage,Ovum number,good quality embryo rate,embryo implantion rate,clinical pregnancy rate and early spontaneous abortion rate in two groups. Conclusions For experienced laparoscopic surgeons,LESS is a safe and feasible procedure with similar perioperative outcomes to multi-incision laparoscopic surgery.

Terapia Su Jok en pacientes con diagnóstico de hidrosalpinx / Su Jok therapy in patients with hydrosalpinx diagnosis

Se realizó un estudio cuasiexperimental de 56 pacientes con diagnóstico de hidrosalpinx, que acudieron a la consulta de Medicina Natural y Tradicional del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba - remitidas de las consultas de Ginecología e Infertilidad -, desde septiembre de 2014 hasta diciembre de 2015, para evaluar la respuesta a la terapia Su Jok. Entre las variables analizadas figuraron: edad, factores de riesgo, manifestaciones clínicas, síndromes tradicionales, evolución clínica y respuesta al tratamiento. En la casuística predominaron las féminas de 30-39 años, la enfermedad inflamatoria pélvica y las infecciones de trasmisión sexual como antecedentes patológicos (71,4 por ciento), el dolor y la secreción vaginal como síntomas principales, así como el estancamiento de Qi de hígado, Qi de riñón no firme y frío-humedad en bazo como síndromes más frecuentes. Finalmente, se logró una evolución favorable y una respuesta adecuada al tratamiento

A quasi-experiment of 56 patients with hydrosalpinx diagnosis that went to the Natural and Traditional Medicine Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba - referred from the Gynecology and Infertility Services -, was carried out from September, 2014 to December, 2015, to evaluate the response to Su Jok therapy. Among the analyzed variables there were: age, risk factors, clinical features, traditional syndromes, clinical course and response to the treatment. In the case material there was a prevalence of women aged 30-39, pelvic inflammatory disease and sexually transmitted infections as pathological history (71.4 percent), pain and vaginal secretion as main symptoms, as well as Qi liver stagnation, not firm Qi kidney and coldness-humidity in spleen as most frequent syndromes. Finally, there was a favorable clinical course and an appropriate response to the treatment

The treatment of hydrosalpinx before in vitro fertilization and embryo transplant / 介入放射学杂志

Objective To treat hydrosalpinx by using interventional embolization of fallopian tube or laparoscopic salpingectomy before the performance of auxiliary reproductive technology,i.e.in vitro fertilization and embryo transplant (IVF-ET),and to compare the clinical effect,technical advantages and disadvamages between the two methods.Methods A total of 170 patients with tubal infertility who had received IVF-ET were selected,the clinical data were retrospectively analyzed.The patients were divided into three groups:(1) interventional embolization group (n=65),using interventional embolization for hydrosalpinx;(2) laparoscopic salpingectomy group (n=55),adopting laparoscopic salpingectomy for hydrosalpinx;and (3) control group (n=50):for these patients bilateral proximal fallopian tube obstruction was performed,and IVF-ET was directly carried out if the patient had no hydrosalpinx.Results No statistically significant differences in the used dosage of gonadotropin (Gn),E2 level on HCG-injection day,the number of follicles on HCG-injection day,the number of retrieved oocytes,the fertilization rate,cleavage rate,clinical pregnancy rate,abortion rate,and ectopic pregnancy rate existed between each other among the three groups (P＞0.05).The technical success rate in both interventional embolization group and laparoscopic salpingectomy group was 100％.No severe complications occurred.The interventional embolization procedure had some advantages,it could be completed at clinic room,the operation time was short,no anesthesia was needed,the medical cost was low,etc.Conclusion Interventional embolization of fallopian tube and laparoscopic resection are equally effective in treating hydrosalpinx before IVF-ET is conducted.Both methods can improve pregnancy outcome,but interventional embolization method is more simple,safe,economical and effective,which deserves to be the preferred method of treatment.

Hydrosalpinx treated by different laparoscopic surgeries and their pregnant outcome (77 cases) / 中国内镜杂志

Objective To study the reproductive outcome of infertile women suffered from hydrosalpinx treated by laparoscopic salpingostomy or salpingectomy.Methods There were 77 infertile women diagnosed hydrosalpinx by HSG or B ultrasonography and excepted for other infertile factors. Unilateral or bilateral salpingostomy or salpingectomy was performed after hydrosalpinx conifrmed by laparoscopy. Seventy seven patients were followed up for 1 ~ 4 years postoperatively.Results Among 77 cases 39 cases (50.65%) got pregnancy. Thirteen cases (16.88%) conceived spontaneously and 26 cases (33.77%) conceived by IVF-ETin. Thirty ifve cases delivered health babies and 3 cases of pregnancy, 1 cases of early abortion.Conclusion Both laparoscopic surgeries were effective treatment of hydrosalpinx results in infertility. After operation the pregnant rate of those conceived by IVF-ET is higher than spontaneously.

MSCT and MRI findings of hydrosalpinx / 实用放射学杂志

Objective To explore the MSCT and MRI characteristics of hydrosalpinx.Methods The CT and MRI findings of 28 patients with hydrosalpinx confirmed by surgery and pathology were retrospectively studied.Before operation,the plain and contrast enhanced CT in 25 patients and the plain and contrast enhanced MRI in 3 had been carried out.Results 1 9 patients with unilateral hydrosalpinx (12 on the left and 7 on the right side)and 9 patients with bilateral hydrosalpinx were found.Both CT and MRI images showed the cystic mass with different forms in annex area,including botuliform changes in 1 6 patients,beaded form in 9,polycystic changes in 8 and retort-like changes in 4.The low density as water on plain CT,and the low signal on T1 WI and high signal on T2 WI were showed.The cystic walls were significantly enhanced without nodules.If there is septum,mild enhancement was also found.14 patients with chronic salpingitis,2 with fascial thickening,3 with uterine fibroid and 1 7 with pelvic fluid.Conclusion CT and MRI findings of hydrosalpinx are characteristic.

MRI diagnosis of the hydrosalpinx and the clinical application value / 实用放射学杂志

Objective To analyze the MRI features of hydrosalpinx and to investigate its clinical value.Methods MRI and ultrasound manifestations in 40 patients with hydrosalpinx in 53 fallopian tubes confirmed by operative and pathological findings were analyzed retrospectively,and these findings were also compared with the results of aparoscopy and pathology.Results Among 53 fallopian tubes with hydrosalpinx,bilateral tubes in 13 patients and 27 unilateral tubes in other patients were found.The tubes were botuliform in 32, retort-shaped in 1 6,pouch-shaped in 5.Incomplete separation of the lumen were found in 1 9.In 9 patients with acute salpingitis,1 5 tubes were found with empyema and expansion.In other 31 patients with chronic salpingitis,38 tubes were with hydrops and expansion,14 of whom were with hematocele.The sensibilities of MRI and ultrasound diagnosis for hydrosalpinx were 94.3%(50/53)and 88.7%(47/53)with no statistical differences(P >0.05),however the specificitis were 90.6%(48/53)and 77.6%(41/53)with obvious statistical differences(P <0.05).Conclusion The locating and qualitative diagnosis of MRI for hydrosalpinx is superior to ultrasound.MRI can discriminate the quality of cyst fluid and thus can definitely diagnose the hydrosalpinx caused by acute or chronic salpingitis.

Endometrial fluid associated with Essure implants placed before in vitro fertilization: Considerations for patient counseling and surgical management / 대한생식의학회지

Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

Comparison of Efficacy of Three Methods to Deal with Hydrosalpinx before in vitro Fertilization and Embryo Transfer / 天津医药

Objective To compare three different curative effects on hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET). Methods Patients receiving IVF-ET between January 2011 to December 2013 (n=731) due to tubal factor infertility (hydrosalpinx) were retrospectively analyzed. All patients were divided into four groups. Embolization group underwent fallopian tube embolization (n=257). Colostomy group underwent laparoscopic tubal umbrella end colosto?my (n=193). Excision group underwent laparoscopic tubal excision(n=198). Control group did not undergo any effusion be?fore transplantation (n=83). Results Comparing main indicators of ovarian hyperstimulation (the number of antral follicles, the dosage of gonadotropin (Gn), the number of retrieved oocytes), indicators were better in embolism group, colostomy group and control group than those in excision group. Comparing main indexes of IVF-ET (embryo implantation rate, clinical preg?nancy rate, abortion rate), indicators were better in embolism group, excision group than those in colostomy group while indi?cators in colostomy group were better than those in control group. The pregnancy rate in fallopian tube was the lowest in em?bolism group and excision group, and the highest in control group. Conclusion All three methods of processing hydrosal?pinx before transplantation ended with positive impact on IVF-ET, and fallopian tube embolization has certain advantages over the other two treatment measures.

Research on the application of value of tubal bolt blocking techniquein the pretreatment hydrosalpinx / 实用放射学杂志

Objective To explore the difference of the impact with different hydrosalpinx pretreatment methods in vitro fertiliza-tion-embryo transfer ﹝ IVF-ET ﹞.Methods 160 patients with routine IVF-ET’s hydrosalpinx were random divided into two groups :the first 80 patients undergoing routine bolt blocking the fallopian tubes for the study group;the other 80 patients with rou-tine salpingectomy as control group patients,after treatment,compare the difference on ovarian function between the two groups.Re-sults In the study group,although these difference,the average number of oocytes,fertilization rate,clinical pregnancy rate and other indicators,were not statistically significant (P>0.05),they were higher than the control group;early abortion rate was no significant difference either (P>0.05),but the tubal pregnancy rate was lower than the control group,and the difference was statis-tically significant (P<0.05).Conclusion Tubal bolt blocking technique is an effective method for hydrosalpinx pretreatment,and partly superior than gynecological surgery for keeping ovarian function and IVF-ET treatment targets.So,it has a broad application prospects in vitro fertilization-embryo transfer.

Pyosalpinx and hydrosalpinx in virginal adolescents: report of two cases / Piosálpinx e hidrosálpinx en adolescentes vírgenes: reporte de dos casos

Pyosalpinx and hydrosalpinx are conditions mainly seen in adult women, but also among sexually active adolescents and can bring added hazard to fertility. However, these conditions are very rare in childhood, as well as in adolescent girls who are not sexually active. We are presenting two rare cases of young girls in early puberty with hydrosalpinx and pyosalpinx. Both girls had a history of abdominopelvic surgery in childhood for congenital bowel anomalies and fecal incontinence. Such cases are good reminders that girls with known abdominopelvic anomalies and surgical procedures in childhood need long term followup, in particular when entering puberty and maturation. The two cases show how fallopian tubes can be indirectly affected and present in adolescence with serious problems needing surgical procedures and potentially threatening future reproductive system performances.

El piosálpinx y el hidrosálpinx son condiciones vistas principalmente en mujeres adultas, pero también entre las adolescentes sexualmente activas, y pueden acarrear riesgos a la fertilidad. Sin embargo, estas condiciones son muy raras en la infancia, así como en las niñas adolescentes que no están sexualmente activas. Presentamos dos casos raros de jovencitas en la pubertad temprana con hidrosálpinx y piosálpinx. Ambas adolescentes tenían antecedentes de cirugía abdominopélvica en la infancia a causa de anomalías congénitas del intestino e incontinencia fecal. Tales casos son buenos recordatorios de que las muchachas con anomalías y procedimientos quirúrgicos abdominopélvicos en la niñez, necesitan seguimiento a largo plazo, en particular al entrar en la pubertad y la madurez. Los dos casos muestran cómo las trompas de Falopio pueden ser indirectamente afectadas, y presentarse en la adolescencia con graves problemas que necesitan procedimientos quirúrgicos y operaciones que constituyen una amenaza potencial al sistema reproductor.

El futuro de la cirugía reproductiva

Es necesario revisar la intervención de la cirugía reproductiva desde la perspectiva de un tratamiento preparatorio para el de fecundación in vitro (FIV). Si hay hidrosálpinx, es necesaria una salpingectomia laparoscópica antes de ingresar a un programa de FIV, considerando que la cirugía no compromete la estimulación ovárica ni las tasas de embarazo con respecto a las pacientes con las trompas sanas. No se ha demostrado alteraciones en los índices de implantación ni de embarazo por efecto de la endometriosis; por tanto, no vale la pena llevar a la paciente a los riesgos de una cirugía. Frente a una ligadura de trompas, los mejores resultados se logran si se llevó a cabo por aplicación de clips en el parte media del istmo, y los peores cuando el procedimiento se realizó distalmente con la eliminación del extremo fimbrial. Las pacientes con miomas subserosos o intramurales menores a 4 cm, que no afectan la cavidad uterina, tienen resultados de FIV/ICSI similares a las que no los tienen; ellas no requieren una miomectomía. En los casos de pérdida recurrente del embarazo, útero septado y polipectomía (>9 mm), los resultados reproductivos de la resectoscopia (histeroscopia quirúrgica) muestran beneficios significativos. El futuro de la cirugía reproductiva, debe considerar preservar la capacidad de tener hijos antes de pensar en eliminar la patología. Todos los ensayos futuros deberán abordar los posibles efectos a largo plazo en detrimento de la fertilidad femenina.

It is necessary to review reproductive surgery from the perspective of in vitro fertilization (IVF) preparatory treatment. When hydrosalpinx is present, laparoscopic salpingectomy is required before entering to an IVF program, considering that surgery does not compromise ovarian stimulation or pregnancy rates with respect to patients with healthy fallopian tubes. As rates of implantation and pregnancy are not altered by endometriosis, carrying the patient to surgery risks is not worth. Faced with tubal ligation, best results are achieved when clips were applied in the middle of the isthmus and worst results when the procedure removed the distal end of the fimbria. Patients with less than 4 cm subserosal or intramural fibroids that do not alter the uterine cavity have IVF / ICSI results similar to those that do not have them, and do not require myomectomy. In cases of recurrent pregnancy loss, uterine septum and polypectomy (>9 mm), resectoscopy (by hysteroscopy) shows significant reproductive benefits. The future of reproductive surgery should consider preserving the ability to have children before considering eliminating pathology. All future trials should address the potential female fertility detrimental long-term effects.

Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy / 대한생식의학회지

OBJECTIVE: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. METHODS: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. RESULTS: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. CONCLUSION: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

Isolated torsion of the hydrosalpinx after hysterectomy: A case report / 대한산부인과학회지

Isolated tubal torsion is a rare disease that causes acute lower abdominal pain. In most of cases, the ovary and the fallopian tube are together twisted due to an ovarian tumor, but the fallopian tube alone is rarely twisted. Tubal torsion mainly occurs in fertile women, and it rarely occurs prior to menarche and during menopause. We experienced a case where isolated tubal torsion occurred in a perimenopausal female with total abdominal hysterectomy, while the findings showed a normal ovary. We report this case with a brief review of related literature.

Laparoscopic tubal reconstructive surgery / 한양의대학술지

Tubal and peritoneal factors account for 30% to 40% of cases of female infertility. Tubal factors include damage or obstruction of the fallopian tube. The best technique for diagnosing tubal and peritoneal disease is laparoscopy, and laparoscopic surgery has been used to various tubal conditions (such as laparoscopic fimbrioplasty, salpingectomy, salpingostomy, and tubal reversal). Approximately 1% of the women who undergo tubal sterilization subsequently request reversal of tubal sterilization. Two treatment options are available to women who wished to become pregnant after having tubal sterilization: tubal reversal or in vitro fertilization (IVF). Laparoscopic tubal reversal shows high pregnancy rates similar to laparotomy and superior to the rates reported for IVF. Hydrosalpinx is a common tubal disease that is associated with lower implantation and pregnancy rates. The proper selection of patients for surgical treatment and of the type of surgical technique are essential to achieve good results. For patients with mild tubal disease, good results can be achieved by an experienced surgeon; however, for patients with severe tubal disease, the prognosis of surgery is poor. In these cases, In-vitro fertilization (IVF) is the main line of treatment for infertility caused by hydrosalpinx.