Hydrosalpinx

Fluid-distended tube

Record the observed structure, its side and the interpretation that it represents a fluid-distended fallopian tube.

1. What examination supports fallopian tube origin, and how was an ovarian or paraovarian origin assessed? boundary
2. Which side is affected, and was the opposite tube assessed or merely not visualized? measurement

Anatomical configuration

Keep distal occlusion, uterine communication and measured distension as separate observations.

1. What supports distal occlusion, and is communication with the uterine cavity demonstrated or unknown? measurement
2. What dimensions and wall or fold observations were recorded for each affected tube? measurement

Diagnostic support

Ultrasound, hysterosalpingography and operative assessment can contribute evidence; HSG may be difficult to interpret or falsely suggest blockage. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)

1. Which report supports the diagnosis, and what did it directly observe rather than infer? provenance
2. Do examinations disagree about side, distension or obstruction, and how has that disagreement been assessed? boundary

Unresolved differential

Require explicit assessment of alternative origin or contents when the report does not securely establish hydrosalpinx.

1. What supports hydrosalpinx rather than pus, blood or another cystic adnexal lesion? boundary
2. What additional clinician assessment, if any, is needed before the diagnosis can guide management? action

Cause and symptom attribution

Recognized antecedents include previous infection, surgery, adhesions and endometriosis; some people have no symptoms beyond fertility problems. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)

1. Which antecedent is documented, and what supports attributing this hydrosalpinx to it? provenance
2. Which current symptoms are attributed to the tube, and which require separate evaluation? boundary
3. Does the current presentation require urgent clinical assessment rather than routine follow-up? action

Reproductive consequences

Hydrosalpinx can impair fertility and IVF outcomes and is associated with ectopic pregnancy risk. Individual implications require clinical assessment. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)

1. Is pregnancy desired, and is natural conception or assisted reproduction being considered? action
2. What is known about the other tube and other fertility factors, without assuming that unilateral disease establishes overall infertility? boundary

Option-specific rationale

Selected cases may be considered for repair; salpingectomy or proximal occlusion may address adverse IVF effects when repair is unsuitable. Selection depends on tubal disease and broader fertility circumstances. [ASRM committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/role-of-tubal-surgery-in-the-era-of-assisted-reproductive-technology-a-committee-opinion-2021/)

1. Is the intended objective symptom relief, restoration of tubal passage or management before embryo transfer? action
2. What anatomical evidence, reproductive context and patient preferences support the proposed approach? provenance
3. Which alternatives were discussed, and what decision remains pending? action

Verified follow-up state

Record persistence, recurrence, removal or isolation with supporting evidence; restored patency alone does not establish restored reproductive function. [ASRM committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/role-of-tubal-surgery-in-the-era-of-assisted-reproductive-technology-a-committee-opinion-2021/)

1. What follow-up evidence establishes the current anatomical state on each side? measurement
2. Were symptoms, recurrence and reproductive outcomes assessed separately, and over what interval? measurement

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Regional variation

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these regional variation hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of Hydrosalpinx this model covers, and on what evidence? provenance