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Hydrosalpinx is one of the predisposing factors of adnexal torsion. However, because the incidence of hydrosalpinx in adolescent virgin patients is very rare, it may cause diagnostic dilemma, leading sometimes to suboptimal treatment. We present the case of an 18-yr-old female, not sexually active, presenting with acute lower right abdominal pain. The working diagnosis was of a simple ovarian cyst, so aspiration was performed. Abdominal symptoms reoccurred and sonography revealed a large hemorrhagic cystic mass adjacent to an edematous right ovary. The patient was referred to immediate laparoscopy due to suspected right adnexal torsion. On laparoscopy, the right adnexa was twisted three times causing an edematous ovary with a hematosalpinx. Detorsion was performed. Five weeks later, transabdominal ultrasound reviled normal bilateral ovaries and the hematosalpinx disappeared. In conclusion, hydrosalpinx, although very rare in adolescence, must be considered in the differential diagnosis. Aspiration in such cases is not the treatment of choice and moreover, it may cause complications.

The influence of a local injection of 0.05 ml/kg weight of 8 mg/ml methotrexate (MTX) was evaluated in 6 rabbit oviducts and compared with saline injections to the contralateral oviducts. Cell cultures of bovine oviducts were incubated in vitro for 7 days and then incubated for 24 h with 100-nmol MTX. Forty-eight and 72 h following the exposure to MTX, the treated and control cultures were harvested. Specimens and cultures were examined by light and scanning electron microscopy. In the in vivo cohort, no differences were observed between MTX and control groups. However, in MTX-treated cell culture, ciliated cells demonstrated partially adherent cilia in about 30% of the cells. The effect of MTX observed only in vitro treated cells may be due to the rapid proliferation of epithelial cells in culture which does not represent the physiological role of the oviduct in vivo.

Even with the most painstaking techniques, cornstarch granules used as surgical glove powder are deposited in the abdominal cavity during laparotomy. In tubal reconstructive surgery, aimed at the elimination of fibrous adhesions, this deposition may have undesirable consequences. After a successful operation, starch particles introduced in the abdominal cavity may result in the formation of new adhesions. It is therefore desirable to develop an alternative, completely nonreactive, glove powder.

A major problem in tubal reconstructive surgery is the recurrence of peritubal and periovarian adhesions which negate the surgical endeavors. In many cases the etiology of these adhesions is obscure. Histologic re-evaluation with polarized light of 49 resected adhesions revealed residual cornstarch glove powder and suture material in seven specimens. It is concluded that cornstarch powder may be an active agent, and may not be as innocuous as its widespread use indicates.

The problem of retrograde seeding of endometrial tissue fragments to the peritoneum was investigated by injecting fluids through the cervical canal into the uterus before and after curettage. Fluid samples were collected from the peritoneal cavity through a laparoscope. Endometrial glands were detected in almost all of the fluids samples, and seeding was greater after curettage than before. It is concluded that any procedure in which fluids are pushed through the uterus may cause peritoneal seeding of endometrium.

Microsurgical fimbriectomy with removal of the fimbria ovarica was performed on one side in 19 rabbits. The other tube was left intact as a control. In 10 animals the new ostium was left free, some distance from the ovary. In the remainder, the ostium was fixed to the ovarian capsule. Three animals with a fixed ostium developed mild hydrosalpinx even though the neostomy was patent. Of the remaining 16 rabbits, 15 conceived and became pregnant in both uterine horns. There was no significant difference between nidation index on the two sides. It is concluded that intact fimbriae with a fimbria ovarica are not essential for normal ovum capture. It is therefore suggested that methods for clinical salpingostomy may require re-evaluation.

It is not fully understood how eggs are captured by the fallopian tube. The close proximity of tube and ovary, and the movements of the fimbria across the ovarian surface during ovulation, are believed to contribute to ovum pickup. We studied the efficiency of ovum capture when contact between fimbria and ovary is prevented and the extent to which ovum transmigration may contribute to fertility. Unilateral right oophorectomy was performed in 55 rabbits, which were divided into three groups: in Group A, the contralateral oviduct was left intact; in Group B, the ampulla of the contralateral oviduct was occluded; in Group C, contralateral total salpingectomy was performed. None of the rabbits in Group A conceived on the oophorectomized side. Seven of 19 animals became pregnant in Group B and 15 of 18 conceived in Group C. The results indicate that direct fimbrial-ovarian contact is not essential for ovum capture, and that ovum transmigration could contribute to fertility.