Nodular salpingitis and tubal endometriosis. II. Diagnosis and differential diagnosis.

Nodular salpingitis and tubal endometriosis are dystrophic disorders (salpingioses) the clinical importance of which is mainly due to their interference with female fertility. We have studied 42 cases of women operated for tubal sterility, viz. 23 cases of nodular salpingitis (NS), 17 of endometriosis (EM) and two cases in which both lesions were present. Pre-operative x-ray and celioscopic exploration was performed in order to assess the severity of the lesions and the outlook after tubal plastic surgery. X-ray examination reveals the diverticular nature of these lesions. Both diseases may be localized in any of the tubal segments. The postoperative prognosis depends on early surgery, site of the lesion and its nature.

Nodular salpingitis and tubal endometriosis. I. Comparative clinical study.

Nodular salpingitis and tubal endometriosis have been referred to in succession as salpingiosis, diverticulosis, adenomyosis of the oviduct, endometrioid conditions, etc. This varied terminology underscores their etiopathogenetic and morphological substratum which is different from that of non specific tubal inflammation, but at the same time this variety of terms has always created confusion in interpretation and diagnosis. We have considered it necessary to carry out a comparative study of nodular salpingitis and tubal endometriosis in 42 cases of sterility operated during the last two years for tubal obstruction and in which histological examination has yielded evidence for the lesions of nodular salpingitis (NS) or endometriosis (EM) in at least one of the oviducts. As for the etiology of the two diseases, we have discussed the role plaid by inflammatory conditions, uterine trauma (curettage) and dystrophic disorders, as well as the importance of hyperandrogenism in NS. Taking into account the diffuse sclerogenic tendency of the tubal wall in NS and the concomitant inflammatory and dystrophic lesions in the peritubal tissues in EM, the postoperative outlook depends on early surgery, to be performed before tubal anatomy has been completely altered.