SALPINGOSCOPIC FINDINGS IN WOMEN WITH OCCLUSIVE AND NONOCCLUSIVE SALPINGITIS ISTHMICA NODOSA

Study Objective: To characterize ampullary endosalpingeal findings in women with occlusive or nonocclusive salpingitis isthmica nodosa. Design: Prospective case study. Setting: Obstetrics and Gynecology Department of a University Hospital. Patients: Twenty women (38 tubes) with occlusive or nonocclusive salpingitis isthmica nodosa were studied. Interventions: Salpingoscopy was performed during diagnostic laparoscopy in 20 women (38 tubes) with hysterosalpingographic evidence of salpingitis isthmica nodosa. Main Outcome Measures: Salpingoscopic findings were recorded and the patients were managed accordingly. Results: Of the 38 tubes 10 appeared radiographically and laparoscopically normal. Two tubes were occluded distally. Of the 26 tubes with occlusive or nonocclusive salpingitis isthmica nodosa, 5 (19.2%) showed varying degrees of endosalpingeal abnormality. Patients with abnormal salpingoscopy were regarded as having bipolar tubal disease and were referred for assisted conception. The remaining patients were scheduled for microsurgical tubal reconstruction. Conclusions: One in five patients with proximal tubal disease may have ampullary endosalpingeal damage of varying degrees. However, the significance of this finding in relation to subsequent management strategies and fertility outcome is yet to be characterized.