About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Procedure for reviewingReviewers 2023-2024
ISSN 0300-9092 (Print)
ISSN 2412-5679 (Online)
About
The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Procedure for reviewingReviewers 2023-2024
Logout
Obstetrics and Gynegology2026№6

Intrauterine pathology in women of reproductive age: a focus on the tubal angles

DOI
https://dx.doi.org/10.18565/aig.2025.361

Petrova O.P., Sulima A.N.

1) Order of the Labor Red Banner Medical Institute named after S.I. Georgievsky of V.I. Vernadsky Сrimean Federal University, Simferopol, Russia, Simferopol, Russia; 2) Harmonia Med LLC, Simferopol, Russia

Intrauterine pathology is one of the leading causes of reproductive dysfunction in women. According to the literature, 25% to 50% of cases of infertility, miscarriage, and abnormal uterine bleeding are associated with organic pathology of the uterine cavity. The tubal angles of the uterus are one of the key, yet underestimated, areas where local changes can significantly affect women’s reproductive health.
This review analyzes and summarizes the existing literature on intrauterine pathology localized in the tubal angles. The multifactorial pathogenetic mechanisms underlying the development of tubal angle pathology are studied and described. Most of the studies conducted from 2018 to 2025 provide the overall incidence of the pathology or demonstrate individual case series describing localization in the angles, but do not present systematic statistics. The diagnosis and differentiation of tubal angle pathology are of significant clinical importance for preserving women’s reproductive health and fertility, as well as for the timely treatment of precancerous endometrial lesions. This paper reviews diagnostic techniques, describing the stages involved and the significance of each in clinical practice.
Conclusion. The tubal angles of the uterus are an underrecognized region where local changes, combined with systemic factors, significantly influence not only the development of intrauterine pathology but also fertility and pregnancy outcomes. The current situation requires a detailed study of the morphological structure and functional characteristics of this region, the identification of potential predictors, and the subsequent development of diagnostic criteria and strategies to prevent recurrence.

Authors’ contributions. Sulima A.N. – developing the concept and design of the study, editing the article; Petrova O.P. – collecting and processing the material, writing the text.
Conflicts of interest. Authors declare lack of the possible conflicts of interest.
Funding. The study was conducted without sponsorship. 
Generative Artificial Intelligence. The technology of using artificial intelligence was not used when writing the text of the article.
For citation: Petrova O.P., Sulima A.N. Intrauterine pathology in women of reproductive age: a focus on the tubal angles.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (6): 31-36 (in Russian)
https://dx.doi.org/10.18565/aig.2025.361

Keywords

tubal angles
interstitial portion of the fallopian tube
organic intrauterine pathology
reproductive age
diagnosis
management
Full text (in Russian)

References

  1. Bonne S., Pouget O., Rongieres C. Fisiología de la trompa. EMC-Ginecologia-Obstetricia. 2016; 52(1): 1-8. https://dx.doi/org/10.1016/S1283-081X(15)76282-X
  2. Pwint P.K., Preethi R., Tara M., Priyanka J. MR of fallopian tubes. Magnetic Resonance Imaging Clinics of North America. 2022; 31(4). https://dx.doi/org/10.1016/j.mric.2022.06.008
  3. Саркисов С.Э., Уланкина О.Г., Хужокова И.Н. Гистерорезектоскопические технологии в лечении гиперпластических процессов эндометрия. Акушерство и гинекология. 2011; 2: 34-7. [Sarkisov S.E., Ulankina O.G., Khuzhokova I.N. Hysteroresectoscopic technologies in the treatment of endometrial hyperplastic processes. Obstetrics and Gynecology. 2011; (2): 34-7 (in Russian)].
  4. Finlinson A.R, Bollig K.J, Schust D.J. Differentiating pregnancies near the uterotubal junction (angular, cornual, and interstitial): a review and recommendations Fertil. Res. Pract. 2020; 6: 8. https://dx.doi/org/10.1186/s 40738-020-00077-0
  5. Кондриков Н.И. Патология матки. М.: Практическая медицина; 2019. 352 с. [Kondrikov N.I. Pathology of the uterus. Moscow: Practical Medicine; 2019: 352 p. (in Russian)].
  6. Lessey B.A, Young S.L, Strauss J.F, Barbieri R. Yen and Jaffe's Reproductive Endocrinology. Elsevier; 2019: 206-47.
  7. Cousins F.L., Filby C.E., Gargett C.E. Endometrial stem/progenitor cells–their role in endometrial repair and regeneration. Front. Reprod. Health. 2022; 3: 811537. https://dx.doi/org/10.3389/frph.2021.811537
  8. Yamaguchi M., Yoshihara K., Suda K., Nakaoka H., Yoshida N., Ueda H. et al. Three-dimensional understanding of the morphological complexity of the human uterine endometrium. iScience. 2021; 24(4): 102258. https://dx.doi/org/10.1016/j.isci.2021.102258
  9. Royal College of Obstetricians and Gynaecologists. Management of endometrial hyperplasia: RCOG/BSGE Green-top Guideline No. 67. February 2016. Available at: https://www.rcog.org.uk/media/knmjbj5c/gtg_67_endometrial_hyperplasia.pdf
  10. Сухих Г.Т., ред. Клиническая анатомия женского таза: иллюстрированный авторский цикл лекций. М.: ГЭОТАР-Медиа; 2021. 152 с. [Sukhikh G.T., ed. Clinical anatomy of the female pelvis: an illustrated author lecture series. Moscow: GEOTAR-Media; 2021. 152 p. (in Russian)].
  11. Zhu X., Yu F., Yan G., Hu Y., Sun H., Ding L. Human endometrial perivascular stem cells exhibit a limited potential to regenerate endometrium after xenotransplantation. Hum. Reprod. 2021; 36(1): 145-59. https://dx.doi/org/10.1093/humrep/deaa261
  12. Murali R., Soslow R.A., Oliva E. High-grade endometrial carcinoma: morphological and immunohistochemical features, diagnostic challenges and recommendations. Int. J. Gynecol. Pathol. 2018; 38(1): 40-63. https://dx.doi/org/10.1097/PGP 0000000000000491
  13. Anca-Stanciu M.B., Manu A., Olinca M.V., Coroleucă C., Comandașu D.E., Coroleuca C.A. et al. Comprehensive review of endometrial cancer: new molecular and clinical insights. J. Clin. Med. 2025; 14(4): 1385. https://dx.doi/org/10.3390/jcm14041385
  14. DeLair D.F., Burke K.A., Selenica P., Lim R.S., Scott S.N., Middha S. et al. The genetic landscape of endometrial clear cell carcinomas. J. Pathol. 2017; 243(2): 230-41. https://dx.doi/org/10.1002/path.4947
  15. Singh N., Hirschowitz L., Zaino R., Alvarado-Cabrero I., Duggan M.A., Ali-Fehmi R. et al. Pathologic prognostic factors in endometrial carcinoma (other than tumor type and grade). Int. J. Gynecol. Pathol. 2019; 38 (Suppl. 1): S93-113. https://dx.doi/org/10.1097/PGP.0000000000000524
  16. Vieira M.D.C., Vitagliano A., Rossette M.C. Endometrial polyps: update ovarian on etiology, diagnosis, natural history and treatment. Clin. Exp. Obstet. Gynecol. 2022; 49(10): 232. https://dx.doi/org/10.31083/ j.ceog 4910232
  17. Mahdy H., Vadakekut E.S., Crotzer D. Endometrial сancer. 2024 Apr 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–.
  18. McCluggage W.G. New histopathological and molecular findings in gynecological cancers. Int. J. Gynaecol. Obstet. 2025; 171(Suppl. 1): 109-19. https://dx.doi/org/10.1002/ijgo.70283
  19. Yu K., Huang Z.Y., Xu X.L., Li J., Fu X.W., Deng S.L. Estrogen receptor function: impact on the human endometrium. Front. Endocrinol. 2022; 13: 827724. https://dx.doi/org/10.3389/fendo.2022.827724
  20. Cetin F., Kayar İ., Birge Ö., Goc G. Malignancy risk factors based on endometrial polyp. BMC Womens Health. 2024; 24(1): 567. https://dx.doi/org/10.1186/s12905-024-03406-3
  21. Ivory A., Greene A.S. Distinct roles of estrone and estradiol in endothelial colony-forming cells. Physiol. Rep. 2023; 11(19): e15818. https://dx.doi/org/10.14814/phy2.15818
  22. Kolhe S. Management of abnormal uterine bleeding - focus on ambulatory hysteroscopy. Int. J. Womens Health. 2018; 10: 127-36. https://dx.doi/org/10.2147/ISWH.S98579
  23. Чернуха Г.Е., Асатурова А.В., Иванов И.А., Думановская М.Р. Структура патологии эндометрия в различные возрастные периоды. Акушерство и гинекология. 2018; 8: 129-34. https://dx.doi.org/10.18565/aig.2018.8.129-134 [Chernukha G.E., Asaturova A.V., Ivanov I.A., Dumanovskaya M.R. Endometrial lesion’s pattern in different age groups.Obstetrics and Gynecology. 2018; (8): 129-34. (in Russian). https://dx.doi.org/10.18565/aig.2018.8.129-134].
  24. Clark T.J., Stevenson H. Endometrial polyps and abnormal uterine bleeding (AUB-P) – what is the relationship; how are they diagnosed and how are they treated? Best Pract. Res. Clin. Obstet. Gynaecol. 2017; 40: 89-104. https://dx.doi/org/10.1016/j.bpobgyn.2016.09.005
  25. Nijkang N.P., Anderson L., Markham R., Manconi F. Endometrial polyps: pathogenesis, sequelae and treatment. SAGE Open Med. 2019; 7: 2050312119848247. https://dx.doi/org/10.1177/2050312119848247
  26. Нейштадт Э.Л., Ожиганова И.Н. Опухоли женской репродуктивной системы. Распознавание и дифференциальная диагностика. Руководство для врачей. М.: Практическая медицина; 2024. 520 с. [Neishtadt E.L., Ozhiganova I.N. Tumors of the female reproductive system. Recognition and differential diagnostics. Manual for physicians. Moscow: Practical Medicine; 2024. 520 p. (in Russian)].
  27. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Полипы эндометрия. 2024. [Ministry of Health of the Russian Federation. Clinical guidelines. Endometrial polyps. 2024 (in Russian)].
  28. Cornel K.M.C., Bongers M.Y., Kruitwagen R.P.F.M., Romano A. Local estrogen metabolism (intracrinology) in endometrial cancer: a systematic review. Mol. Cell. Endocrinol. 2019; 489: 45-65. https://dx.doi/org/10.1016/j.mce.2018.10.004
  29. Габидуллина Р.И., Смирнова Г.А., Ганеева А.В., Валеева Е.В., Зарипова А.Ш. Взаимосвязь аллелей и генотипов полиморфизма RS2414098 гена CYP19A1 с риском возникновения полипов эндометрия. Российский вестник акушера-гинеколога. 2022; 22(3): 6-10. https://dx.doi/org/10.17116/rosakush2022220386 [Gabidullina R.I., Smirnova G.A., Ganeeva A.V., Valeeva E.V., Zaripova A.Sh. The relationship of genotypes of the RS2414098 polymorphism of the CYP19A1 gene with the risk of endometrial polyps. Russian Bulletin of Obstetrician-Gynecologist. 2022; 22(3): 6‑11 (in Russian). https://dx.doi/org/10.17116/rosakush2022220386]
  30. Takashi T., Kouji B., Yusuke K., Masataka A., Megumi Y., Eiichiro T. et al. Mutations of RAS genes in endometrial polyps. J. Oncology. 2019; 42(6): 2303-8. https://dx.doi/org/10.3892/or.2019.7353
  31. Doria P.L.S., Moscovitz T., Tcherniakovsky M., Fernandes C.E., Pompei L.M., Wajman M. et al. Association of IGF-1 CA(n) and IGFBP3 rs2854746 polymorphisms with endometrial polyp risk. Biomed Res. Int. 2018; 2018: 8704346. https://dx.doi/org/10.1155/2018/8704346
  32. Mansour T., Chowdhury Y.S. Endometrial polyp. 2023 Apr 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–.
  33. Siferih M., Gebre T., Hunduma F., Abebe A., Gebremichael A., Sewunet H. et al. Review of Asherman syndrome and its hysteroscopic treatment outcomes: experience in a low-resource setting. BMC Womens Health. 2024; 24(1): 99. https://dx.doi/org/10.1186/s 12905-024-02944-0
  34. Khan Z., Goldberg J.M. Hysteroscopic management of Asherman’s syndrome. J. Minim. Invasive Gynecol. 2018; 25(2): 218-28. https://dx.doi/org/10.1016/j.jmig.2017.09.020
  35. Salazar C.A., Isaacson K., Morris S. A comprehensive review of Asherman’s syndrome: causes, symptoms and treatment options. Curr. Opin Obst. Gynecol. 2017; 29(4): 249-56. https://dx.doi/org/10.1097/GCO0000000000000378
  36. Dreisler E., Kjer J.J. Asherman’s syndrome: current perspectives on diagnosis and management. Int. J. Women’s Health. 2019; 11: 191-8. https://dx.doi/org/10.2147/ IJWH.S165474
  37. Zhang Z., Li S., Deng J., Yang S., Xiang Z., Guo H. et al. Aspirin inhibits endometrial fibrosis by suppressing the TGF‑β1‑Smad2/Smad3 pathway in intrauterine adhesions. Int. J. Mol. Med. 2020; 45(5): 1351-60. https://dx.doi/org/10.3892/IJMM.2020.4506
  38. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Аменорея и олигоменорея. 2024. [Ministry of Health of the Russian Federation. Clinical guidelines. Amenorrhea and oligomenorrhea. 2024 (in Russian)].
  39. Fernandez H., Benifla J.L., Fritel X., Fallet C. Synéchies post-curetage et aspiration: intérêt d'un anti-adhérentiel? [Post-curettage and aspiration synechiae: is there value in an anti-adhesion agent?]. J. Gynecol. Obstet. Biol. Reprod. (Paris). 2012; 41(2): H8-12. French. https://dx.doi/org/10.1016/S0368-2315(12)70004-2
  40. Думановская М.Р., Чернуха Г.Е., Табеева Г.И., Асатурова А.В. Гиперплазия эндометрия: поиск оптимальных решений и стратегий. Акушерство и гинекология. 2021; 4: 23-31. https://dx.doi/org/10.18565/aig.2021.4.23-31. [Dumanovskaya M.R., Chernukha G.E., Tabeeva G.I., Asaturova A.V. Endometrial hyperplasia: search for optimal solutions and strategies. Obstetrics and Gynecology. 2021; (4): 23-31 (in Russian). https://dx.doi/org/10.18565/aig.2021.4.23-31].
  41. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Гиперплазия эндометрия. 2025. [Ministry of Health of the Russian Federation. Clinical guidelines. Endometrial hyperplasia. 2025 (in Russian)].
  42. Giambanco L., Iannone V., Borriello M., Sozzi G., Scibilia G., Chiantera V. et al. Multicentric study on endometrial polyps and endometriosis: are they true or false friends? Open Journal of Obstetrics and Gynecology. 2020; 10: 873-9. https://dx.doi/org/10.4236/ojog.2020.1070081
  43. Bulun S.E., Yilmaz B.D., Sison C., Miyazaki K., Bernardi L., Liu S. et al. Endometriosis. Endocr. Rev. 2019; 40(4): 1048-79. https://dx.doi/org/10.1210/er.2018-00242
  44. Hill C.J., Fakhreldin M., Maclean A., Dobson L., Nancarrow L., Bradfield A. et al. Endometriosis and the fallopian tubes: theories of origin and clinical implications. J. Clin. Med. 2020; 9(6): 1905. https://dx.doi/org/10.3390/jcm9061905
  45. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Эндометриоз. 2024. [Ministry of Health of the Russian Federation. Clinical guidelines. Uterine fibroids. 2024 (in Russian)].
  46. Tîrnovanu M.C., Lozneanu L., Tîrnovanu Ş.D., Tîrnovanu V.G., Onofriescu M., Ungureanu C. et al. Uterine fibroids and pregnancy: a review of the challenges from a romanian tertiary level institution. Healthcare (Basel). 2022; 10(5): 855. https://dx.doi/org/10.3390/healthcare.10050855
  47. Lasmar R.B., Lasmar B.P., Moawad N.S. Hysteroscopic myomectomy. Medicina (Kaunas). 2022; 58(11): 1627. https://dx.doi/org/10.3390/medicina 58111627
  48. Csöbönyeiová M., Klein M., Feitscherová C., Pavlíková L., Kachlík D., Varga I. The overview of anatomical variations and congenital anomalies of the uterine tubes and their impact on fertility. Physiol. Res. 2022; 71(Suppl. 1): S35-49. https://dx.doi/org/10.33549/physiolres.935035
  49. Kahramanoglu I., Mammadov Z., Turan H., Urer A., Tuten A. Management options for interstitial ectopic pregnancies: a case series. Pak. J. Med. Sci. 2017; 33(2): 476-82. https://dx.doi/org/10.12669/pjms.33212093
  50. Densley A., Shonnard M., Conklin M., Menghani V., Reddy-Moolamalla S. Angular and interstitial ectopic pregnancies: a clarification of terms and literature review. Curr. Probl. Diagn. Radiol. 2023; 52(2): 84-8. https://dx.doi/org/10.1067/j.cpradial.2022.11.005
  51. Di Spiezio Sardo A., Calagna G., Santangelo F., Zizolfi B., Tanos V., Perino A. et al. The role of hysteroscopy in the diagnosis and treatment of adenomyosis. Biomed. Res. Int. 2017; 2017: 2518396. https://dx.doi/org/10.1155/2017/2518396

Received 09.12.2025

Accepted 09.06.2026

About the Authors

Oksana P. Petrova, Аpplicant at the Department of Obstetrics, Gynecology and Perinatology No. 1, Order of the Labor Red Banner Medical Institute named after
S.I. Georgievsky of V.I. Vernadsky Сrimean Federal University, 295051, Russia, Simferopol, Lenin Blvd., 5/7; obstetrician-gynecologist, “HARMONY MED” LLC, 295015, Russia, Simferopol, Kozlova str., 41, +7(978)015-80-04, petrovka_71@mail.ru, https://orcid.org/0000-0002-1098-0546
Anna N. Sulima, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology and Perinatology No. 1, Order of the Labor Red Banner Medical Institute named after S.I. Georgievsky of V.I. Vernadsky Сrimean Federal University, 295051, Russia, Simferopol, Lenin Blvd., 5/7, +7(978)764-82-00, gsulima@yandex.ru,
https://orcid.org/0000-0002-2671-6985
Corresponding author: Anna N. Sulima, gsulima@yandex.ru

Similar Articles

№7 / 2025
Dubinskaya E.D., Gasparov A.S., Matskevich E.N.
Clinical and anatomical features of patients with apical prolapse
№3 / 2024
Volkov A.E., Solonchenko A.S., Rymashevsky A.N., Voloshin V.V., Khloponina A.V., Kantsurova M.R.
Early diagnosis of abnormally deep invasion of the chorion as a predictor of invasive placentation
№9 / 2024
Sulima A.N., Bakharovskaya A.S.
Cesarean scar ectopic pregnancy
№8 / 2024
Dubinskaya E.D., Kolesnikova S.N., Alyoshkina E.V., Gasparov A.S.
Clinical risk factors for infertility in reproductive-age patients with intramural uterine fibroids
№11 / 2024
Prikhodko A.M., Amiraslanov E.Yu., Chuprynin V.D., Kan N.E., Baev O.R.
Algorithm for providing medical care to patients with placenta percreta
By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.