ABSTRACT
This chapter discusses the various congenital tubal and para-tubal pathology, its consequences, diagnosis, and surgical treatment. It reviews the association between early stage of endometriosis and subtle fimbrial pathology. Subtle distal tubal pathology has been associated with early stages of endometriosis. Fimbrial end pathology can be divided into: Fimbrial agglutination, Fimbrial blunting, and Fimbrial phimosis. Once distal tubal pathology is suspected, a thorough history should be obtained from the patient, including menstrual history, history of dysmenorrheal, dyspareunia, and pelvic pain. In addition, any history of infertility, sexually transmitted diseases, pelvic inflammatory disease, appendicitis, bowel inflammatory disease, and previous surgical procedures should be reviewed. During laparoscopy, surgical correction in the form of tubal reconstruction can also be simultaneously performed by an experienced surgeon. It is thus prudent that diagnostic laparoscopy be performed by a trained surgeon comfortable with not only identifying such pathology, but also in performing reconstructive tubal surgery.
