Salpingitis isthmica nodosa: a review of the literature, discussion of clinical significance, and consideration of patient management.
OBJECTIVE
To examine and discuss the pathology, diagnosis, incidence, and patient profile of salpingitis isthmica nodosa and to question its natural history, propose management strategies, and identify areas of promising research.


METHODS
Over 50 studies were reviewed, evaluated, and compared to offer the clinician a foundation on which to generate treatment plans.


RESULTS
Salpingitis isthmica nodosa is diagnosed by the pathological presence of isthmic diverticula and may be suggested by characteristic changes on hysterosalpingogram. Its incidence in healthy, fertile women ranges from 0.6% to 11%, but it is significantly more common in the setting of ectopic pregnancy and infertility. There are no studies, retrospective or prospective, that clearly dictate appropriate therapy.


CONCLUSIONS
Given its progressive nature and probable deleterious effects on fertility, we propose that microtubal surgery be the definitive treatment for qualified women who have salpingitis isthmica nodosa.
Jenkins
C S
CS
Department of Obstetrics and Gynecology, Riverside Methodist Hospitals, Columbus, Ohio 43214.
Williams
S R
SR
Schmidt
G E
GE
D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D015994:Incidence; D007247:Infertility, Female / Q000209:etiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D012488:Salpingitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*