Bontis John N, Theodoridis Theodoros D
First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
Ann N Y Acad Sci. 2006 Dec;1092:199-210. doi: 10.1196/annals.1365.017.
Hydrosalpinx is a common cause of female infertility. Lower implantation and pregnancy rates have been reported in women with hydrosalpinges. How hydrosalpinx exerts its negative effect on the implantation process is not clearly understood. Mechanical factors, toxicity of the hydrosalpingeal fluid, and receptivity dysfunction may explain the impaired IVF outcome in the presence of hydrosalpinx. Laparoscopic surgery has a place in the diagnosis and management of hydrosalpinx. Analysis of the results of laparoscopic management of hydrosalpinx underscores the positive role of laparoscopy in fertility outcomes in women with this pathological tubal disease. Laparoscopic salpingectomy should be offered in those women who have bilateral disease or in cases where hydrosalpinges are large enough to be visible on ultrasound. Further randomized trials are required to assess other surgical treatment options for hydrosalpinx, such as laparoscopic salpingostomy, laparoscopic or hysteroscopic tubal occlusion, and drainage of hydrosalpinx before or during oocyte retrieval.
输卵管积水是女性不孕的常见原因。据报道，患有输卵管积水的女性其着床率和妊娠率较低。输卵管积水如何对着床过程产生负面影响尚不清楚。机械因素、输卵管积水液的毒性以及容受性障碍可能解释了存在输卵管积水时体外受精结局受损的原因。腹腔镜手术在输卵管积水的诊断和治疗中具有一定作用。对输卵管积水腹腔镜治疗结果的分析强调了腹腔镜在患有这种病理性输卵管疾病的女性生育结局中的积极作用。对于双侧患病或输卵管积水大到足以在超声下可见的女性，应进行腹腔镜输卵管切除术。需要进一步的随机试验来评估输卵管积水的其他手术治疗选择，如腹腔镜输卵管造口术、腹腔镜或宫腔镜输卵管阻塞以及在取卵前或取卵期间对输卵管积水进行引流。
