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Symptoms can vary. Some patients have lower often recurring abdominal pain or pelvic pain, while others may be asymptomatic. As tubal function is impeded, infertility is a common symptom. Patients who are not trying to get pregnant and have no pain, may go undetected.
Endometriosis, ruptured appendicitis, and abdominal surgery sometimes are associated with the problem. As a reaction to injury, the body rushes inflammatory cells into the area, and inflammation and later healing result in loss of the fimbria and closure of the tube. These infections usually affect both fallopian tubes, and although a hydrosalpinx can be one-sided, the other tube on the opposite side is often abnormal. By the time it is detected, the tubal fluid usually is sterile, and does not contain an active infection. (Not symptoms)
The significance of endosalpingiosis is not settled; medical experts differ on whether the condition itself causes issues or whether it is an asymptomatic finding. Common symptoms include, pelvic pain, infertility, menstrual irregularities and dyspareunia. Further reports suggest chronic back pain as a common issue reported years before diagnosis. Experts are unclear as the condition itself is a rare finding and lack of knowledge presents itself as a challenge.
Like the uterine endometrium of Endometriosis, estrogen can cause salpingoitic tissues outside of the fallopian tubes to grow and potentially aggravate the surrounding areas. High levels cause the glandular tissues to proliferate and, especially important, they cause the number of and activity of ciliated epithelial cells (that would normally line the fallopian tubes) to increase.
Some women with uterine fibroids do not have symptoms. Abdominal pain, anemia and increased bleeding can indicate the presence of fibroids. There may also be pain during intercourse, depending on the location of the fibroid. During pregnancy, they may also be the cause of miscarriage, bleeding, premature labor, or interference with the position of the fetus. A uterine fibroid can cause rectal pressure. The abdomen can grow larger mimicking the appearance of pregnancy. Some large fibroids can extend out through the cervix and vagina.
While fibroids are common, they are not a typical cause for infertility, accounting for about 3% of reasons why a woman may not be able to have a child. The majority of women with uterine fibroids will have normal pregnancy outcomes. In cases of intercurrent uterine fibroids in infertility, a fibroid is typically located in a submucosal position and it is thought that this location may interfere with the function of the lining and the ability of the embryo to implant.
A hydrosalpinx is a distally blocked fallopian tube filled with serous or clear fluid. The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape. The condition is often bilateral and the affected tubes may reach several centimeters in diameter. The blocked tubes cause infertility.
A fallopian tube filled with blood is a hematosalpinx, and with pus a pyosalpinx.
Hydrosalpinx is a composite of the Greek words ὕδωρ (hydōr – "water") and σάλπιγξ (sálpinx – "trumpet"); its plural is "hydrosalpinges".
In gynecology, endosalpingiosis is a condition in which fallopian tube-like epithelium is found outside the fallopian tube. It is unknown what causes this condition. It is generally accepted that the condition develops from transformation of coelomic tissue. It is often an incidental finding and is not usually associated with any pathology.
Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder causing a frequent need to urinate. They may also cause pain during sex or lower back pain. A woman can have one uterine fibroid or many. Occasionally, fibroids may make it difficult to become pregnant, although this is uncommon.
The exact cause of uterine fibroids is unclear. However, fibroids run in families and appear to be partly determined by hormone levels. Risk factors include obesity and eating red meat. Diagnosis can be performed by pelvic examination or medical imaging.
Treatment is typically not needed if there are no symptoms. NSAIDs, such as ibuprofen, may help with pain and bleeding while paracetamol (acetaminophen) may help with pain. Iron supplements may be needed in those with heavy periods. Medications of the gonadotropin releasing hormone agonist class may decrease the size of the fibroids but are expensive and associated with side effects. If greater symptoms are present, surgery to remove the fibroid or uterus may help. Uterine artery embolization may also help. Cancerous versions of fibroids are very rare and are known as leiomyosarcomas. They do not appear to develop from benign fibroids.
About 20% to 80% of women develop fibroids by the age of 50. In 2013, it was estimated that 171 million women were affected. They are typically found during the middle and later reproductive years. After menopause, they usually decrease in size. In the United States, uterine fibroids are a common reason for surgical removal of the uterus.
An interstitial pregnancy is a uterine but ectopic pregnancy; the pregnancy is located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus. The term cornual pregnancy is sometimes used as a synonym, but remains ambiguous as it is also applied to indicate the presence of a pregnancy located within the cavity in one of the two upper "horns" of a bicornuate uterus. Interstitial pregnancies have a higher mortality than ectopics in general.
Hematosalpinx (sometimes also hemosalpinx) is a medical condition involving bleeding into the fallopian tubes.
In premenopausal women, adnexal masses include ovarian cysts, ectopic (tubal) pregnancies, benign (noncancerous) or malignant (cancerous) tumors, endometriomas, polycystic ovaries, and tubo-ovarian abscess. In females of reproductive age, adnexal masses can be physiologic or complex masses. Most common causes for adnexal masses in premenopausal women are follicular cysts and corpus luteum cysts. Abscesses can form as a complication of pelvic inflammatory disease.
Other masses include endometriomas, polycystic ovaries, and benign neoplasms.
In postmenopausal women, adnexal masses may be caused by cancer, fibroids, fibromas, diverticular abscess.
A hematosalpinx from a tubal pregnancy may be associated with pelvic pain and uterine bleeding. A gynecologic ultrasound will show the hematosalpinx. A hematosalpinx from other conditions may be painless but could lead to uterine bleeding.
Some or all of the following symptoms may be present, though it is possible not to experience any symptoms:
- Abdominal pain. Dull aching pain within the abdomen or pelvis, especially during intercourse.
- Uterine bleeding. Pain during or shortly after beginning or end of menstrual period; irregular periods, or abnormal uterine bleeding or spotting.
- Fullness, heaviness, pressure, swelling, or bloating in the abdomen.
- When a cyst ruptures from the ovary, there may be sudden and sharp pain in the lower abdomen on one side.
- Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy.
- Constitutional symptoms such as fatigue, headaches
- Nausea or vomiting
- Weight gain
Other symptoms may depend on the cause of the cysts:
- Symptoms that may occur if the cause of the cysts is polycystic ovarian syndrome (PCOS) may include increased facial hair or body hair, acne, obesity and infertility.
- If the cause is endometriosis, then periods may be heavy, and intercourse painful.
The effect of cysts not related to PCOS on fertility is unclear.
Bleeding before the expected time of menarche could be a sign of precocious puberty. Other possible causes include the presence of a foreign body in the vagina, molestation, vaginal infection (vaginitis), and rarely, a tumor.
An adnexal mass is a lump in tissue of the adnexa of uterus (structures closely related structurally and functionally to the uterus such as the ovaries, fallopian tubes, or any of the surrounding connective tissue). Adnexal masses can be benign or cancerous, and they can be categorized as simple or complex. One of the most important factors used to determine the clinical suspicion of malignancy of an adnexal mass is the sonographic appearance of the mass. Indications that the mass is at a higher risk of being malignant include: presence of loculations, nodules, papillary structures, septations, size greater than 10 cm.
A unicornuate uterus represents a uterine malformation where the uterus is formed from one only of the paired Müllerian ducts while the other Müllerian duct does not develop or only in a rudimentary fashion. The sometimes called "hemi-uterus" has a single horn linked to the ipsilateral fallopian tube that faces its ovary.
Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation, but fertilized within the ovary where the pregnancy implants. Such a pregnancy usually does not proceed past the first four weeks of pregnancy. An untreated ovarian pregnancy causes potentially fatal intraabdominal bleeding and thus may become a medical emergency.
Vaginal adenosis is a benign abnormality in the vagina, commonly thought to be caused by intrauterine and neonatal exposure of diethylstilbestrol and other progestagens and nonsteroidal estrogens, however it has also been observed in otherwise healthy women and has been considered at times idiopathic or congenital. Postpubertal lesions have also been observed to grow . It has a rather common incidence, of about 10% of adult women.
Up to 10% of women with ectopic pregnancy have no symptoms, and one-third have no medical signs. In many cases the symptoms have low specificity, and can be similar to those of other genitourinary and gastrointestinal disorders, such as appendicitis, salpingitis, rupture of a corpus luteum cyst, miscarriage, ovarian torsion or urinary tract infection. Clinical presentation of ectopic pregnancy occurs at a mean of 7.2 weeks after the last normal menstrual period, with a range of 4 to 8 weeks. Later presentations are more common in communities deprived of modern diagnostic ability.
Signs and symptoms of ectopic pregnancy include increased hCG, vaginal bleeding (in varying amounts), sudden lower abdominal pain, pelvic pain, a tender cervix, an adnexal mass, or adnexal tenderness. In the absence of ultrasound or hCG assessment, heavy vaginal bleeding may lead to a misdiagnosis of miscarriage. Nausea, vomiting and diarrhea are more rare symptoms of ectopic pregnancy.
Rupture of an ectopic pregnancy can lead to symptoms such as abdominal distension, tenderness, peritonism and hypovolemic shock. A woman with ectopic pregnancy may be excessively mobile with upright posturing, in order to decrease intrapelvic blood flow, which can lead to swelling of the abdominal cavity and cause additional pain.
A ruptured ovarian cyst is usually self-limiting, and only requires keeping an eye on the situation and pain medications. The main symptom is abdominal pain, which may last a few days to a several weeks, but they can also be asymptomatic. Rupture of large ovarian cysts can cause bleeding inside the abdominal cavity and in some cases shock.
Vaginal bleeding is any bleeding through the vagina, including bleeding from the vaginal wall itself, as well as (and more commonly) bleeding from another location of the female reproductive system, often the uterus. Generally, it is either a healthy physiologic response during the non-conceptional menstrual cycle or is caused by hormonal or other organic problems of the reproductive system, such as abnormal uterine bleeding. Vaginal bleeding may occur at any age, but always needs investigation when encountered in children or in postmenopausal women. Vaginal bleeding during pregnancy may indicate a possible pregnancy complication that needs to be medically addressed.
Blood loss "per vaginam" (Latin: through the vagina) (PV) typically arises from the lining of the uterus (endometrium), but may arise from uterine or cervical lesions, the vagina, and rarely from the fallopian tube. During pregnancy it is usually but not always related to the pregnancy itself. Rarely, the blood may arise from the urinary tract (hematuria), although most women can identify the difference. It can also be a sign of vaginal cancer or uterine cancer.
Colposcopically, it presents itself similarly to columnar epithelium on the cervix, assisted with lugol's solution application for diagnosis. It can be discovered as nodules or cysts on the vaginal tube, with biopsy needed for further diagnosis. As seen cytologically, epithelial and stromal cells in vaginal adenosis show characteristic fusion through the basal lamina or with stromal fibroblasts. Adenosal cells can be distinguished as mucinous, tuboendometrial, and embryonic. Its mucinous cells resemble the normal cervical lining, while its tuboendometrial cells resemble the lining of normal fallopian tubes or endometrium.
It is sometimes considered a precancerous lesion, given clear-cell adenocarcinoma patients present these lesions in close proximity to atypical tuboendometrial glands, and microglandular hyperplasia has been seen to arise from these lesions.
The internal location of the fallopian tubes makes it difficult to reach an early diagnosis. Symptoms are nonspecific and may consist of pain and vaginal discharge or bleeding. A pelvic mass may be detected on a routine gynecologic examination.
Vaginal discharge in fallopian tube carcinoma result from "intermittent hydrosalphinx" that is called as "hydrops tubae profluens".
Most cysts are small and asymptomatic. Typical sizes reported are 1 to 8 cm in diameter. PTCs may be found at surgery or during an imaging examination that is performed for another reason. Larger lesions may reach 20 or more cm in diameter and become symptomatic exerting pressure and pain symptoms in the lower abdomen. Large cysts can lead to torsion of the adnexa inflicting acute pain.
Prior to surgery, PTCs are usually seen on ultrasonography. However, because of the proximity of the ovary that may display follicle cysts, it may be a challenge to identify a cyst as paratubal or paraovarian.
Fallopian tube obstruction is a major cause of female infertility. Blocked fallopian tubes are unable to let the ovum and the sperm converge, thus making fertilization impossible. Fallopian Tubes are also known as oviducts, uterine tubes, and salpinges (singular salpinx).
PTCs are generally benign, but may, on rare occasions, give rise to borderline tumors and malignancies.
The infection usually has its origin in the vagina and ascends to the Fallopian tube from there. Because the infection can spread via the lymph vessels, infection in one Fallopian tube usually leads to infection of the other.