Should I have my hydrosalpinx removed?

Dear Robert,

I have recently been diagnosed with a large left hydrosalpinx- approx 10x8cm which had grown over the last 6 months from 5x6cm. I have had 2 episodes of left iliac fossa pain, which I’m not too sure if it is related to the hydrosalpinx as it resolved over a few hours.

Do you think I should get it taken out? Is there any impact on ovarian function? Can you recommend the best place to get this taken out?

Thank you for your help,


Dear I.,

There really is very little need to remove hydrosalpinges like this – providing that the doctors are sure that it is a hydrosalpinx and not an ovarian cyst for example.  If it twists or gets infected that might be an indication for removal, but probably not otherwise.  If your hydrosalpinx is due to a congenital malformation (which is not quite as uncommon as many doctors think) there is unlikely to be any affect on ovarian function.  If the hydrosalpinx is due to some past infection, or a previous surgical procedure such as an appendicectomy, ovarian function may be a bit impaired but removal does not appear to make much difference.   A number of IVF clinics recommend removal of a hydrosalpinx before IVF but there is no good evidence that this really makes a difference to the pregnancy rate afterwards.

As to pain, hydrosalpinges rarely cause pain, but if they continue to do so, removal may be best and this can be done by any competent gynaecologist – nowadays this is done by keyhole surgery (laparoscopy) but an open operation may be indicated.  The procedure is not dangerous.

Best wishes

Robert Winston