Hysterosalpingography allowed gynecologists and infertility specialists to study the uterine cavity, shape, and any abnormalities that could result from either congenital problems or acquired disease processes. Irregular uterine bleeding is not an uncommon phenomenon during reproductive period. Many of these cases are dysfunctional uterine bleeding that require endocrine evaluation as well as hematologic studies. Salpingography identifies a normal fallopian tube lumen or abnormalities related to iatrogenic factors such as tubal sterilization or pathology as a result of infection and various kinds of obstructive disease. Various pathological conditions have been identified in the isthmic portion of the fallopian tube with the use of hysterosalpingography. One of these conditions is salpingitis isthmica nodosa. Fallopian tube disease is the single most common cause of infertility and women routinely undergo hysterosalpingography in the course of the infertility work-up to evaluate this factor.

Both patency and normal anatomy of the fallopian tube are essential for reproduction. There are many pathological conditions that affect the fallopian tube and consequently affect human reproduction. During the past 28 years, the introduction of in vitro fertilization helped many infertile couples to achieve successes, despite tubal pathology. Salpingitis isthmica nodosa is now believed to be a proliferative process of the endosalpinx into the myosalpinx, leading to hypertropic process and fibrosis in the wall of the fallopian tube and the isthmus. Tubal sterilization is performed for women who have a disease that contraindicates pregnancy. The fallopian tube could be affected with endometriosis directly or indirectly. Surgical management of endometriosis of the fallopian tube follows the same principles of dealing with endometriosis of the pelvic cavity, and this could be accomplished by the use of CO2 laser or harmonic scalpel or microcautery.