Diagnosis and Treatment of Tubal Diverticula: Report of 13 Cases |
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| Affiliation: | 1. INSERM U693 and Univ Paris-Sud 11, Faculté de Médecine Paris-Sud, UMR-S693, Le Kremlin Bicêtre F-94276, France;2. «Carol Davila» University of Medicine and Pharmacy, Bucharest, Romania;3. Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et Maladies de la Reproduction, Le Kremlin Bicêtre F-94275, France;1. Department of Cardiology, Kameda Medical Center, Chiba, Japan;2. Department of Life Science and Bioethics, Tokyo Medical and Dental University, Tokyo, Japan;3. Department of Rheumatology, Kameda Medical Center, Chiba, Japan;4. Department of Epidemiology, Harvard School of Public Health, Boston, Mass;1. Third Surgical Department, “George Gennimatas” General Hospital of Athens, Mesogeion Ave 154, 156 69 Athens, Greece;2. Pathology Department, “George Gennimatas” General Hospital of Athens, Mesogeion Ave 154, 156 69 Athens, Greece;1. Department of Surgery and Cancer, Imperial College, St. Mary''s Hospital, London;2. Department of Obstetrics and Gynecology, Women''s Centre, Imperial College Healthcare NHS Trust, St. Mary''s Hospital, London;3. Nuffield Department of Obstetrics and Gynecology, Oxford University Hospitals NHS Trust, Oxford, UK;4. Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia;1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia;2. Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC;3. Metro Health Medical Center, Case Western Reserve University, Cleveland, Ohio;4. University of Oklahoma, Oklahoma City;5. Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel |
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| Abstract: | Tubal diverticula is a rare disease, and the literature includes only a few reports of this condition. We tentatively summarized 13 cases to investigate the clinical characteristics, diagnosis, and treatment of tubal diverticula. The clinical manifestations, diagnosis at hysterosalpingography (HSG), surgical treatment, and pregnancy rates of the 13 cases were retrospectively analyzed. Tubal diverticula is more prevalent in women with endometriosis than in infertile patients (6.7% vs 2.1%; p = .000). Eleven patients (84.6%) had endometriosis, which was in an early stage (I or II) in 9 patients (81.8%). HSG may reveal accumulation of radiopaque contrast medium around the distal end of the tubes, suggesting the presence of diverticula. All 13 cases were diagnosed via laparoscopy, and the diverticula were resected during surgery. Eleven of the 13 patients (84.6%) had ≥2 subtle tubal abnormalities. The pregnancy rate in 9 of the 11 patients with tubal diverticula was 81.8%, with 1 ectopic pregnancy (11.1%) and 1 spontaneous abortion (12.5%). HSG may be helpful in enabling the diagnosis of tubal diverticula. It is important that tubal diverticula be diagnosed via laparoscopy with use of diluted methylene blue dye and careful evaluation. |
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| Keywords: | Endometriosis HSG Infertility Laparoscopy Tubal diverticula |
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