Surgery for Hydrosalpinx—History, Classification, Incidence, Results, and Recommendation for Management

Terminal tubal obstruction with formation hydrosalpinx results in cellular deciliation, hormone receptor depletion and intraluminal scarring. Fluid secretion, blood flow, and muscular contractility are similarly progressively affected to varying degrees. Intraluminal epithelial damage is best assessed by salpingoscopy or microsalpingoscopy and extratubal pathology by laparoscopy. Hydrosalpinges with severe intratubal pathology require excision and IVF management for fertility. Restorative salpingostomy can be considered at a single endoscopic procedure when salpingoscopy severity scale indicates mild or no significant change. The role of reproductive surgery should be considered complementary to IVF allowing infertile couples the possibility of recurring natural conception.