blocked falopian tubes with cyst

I've had irregular periods for 4 months now. Last period was very heavy and has lasted over 3 weeks. During this time, I've also had 2 occasions whereby I had intense pelvic pain which I needed to remain very still but went away in about 15 minutes. Doctor did ultrasound, determined left falopian tube is blocked at both ends and that I have a cyst 3 1/2 inches wide. He is recommending to have the left tube removed and believes the tube was twisting on those 2 occasions. We are still unclear as to why I am bleeding so much. I've been placed on medroxyprogesterone until surgery which is less than one week. Doctor does not feel I have cancer but we're still awaiting results of RA125. Are there any alternatives to having the surgery?

[Elaine Brown, MD]

Hi!
It sounds to me as though you may have a hydrosalpinx.  The other possibility is a paratubal cyst.  If you were my patient, I would do laparoscopy.  I hope your doctor is not going to start out with a big incision!  I would look inside and find out what we were dealing with.  If it is a paratubal cyst, it could be "popped" and drained and your tube could be left alone.  A paratubal cycle won't come back again.
If it is a hydrosalpinx, I probably would recommend removing it. A hydrosalpinx is usually the result of an old infection in the tube.  Usually the tube is pretty badly damaged, and opening it up can result in tubal pregnancies.  For some reason, hydrosalpinges also reduce success with IVF cycles, so even if you went to IVF they would suggest taking the tube.
There is also no reason why the ovary needs to be removed.  A tube can receive eggs from either the right or left ovary, so I would leave the ovary unless it is involved in the scarring and infection too.
Good luck!
Dr B