Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), Department of Obstetrics and Gynecology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Introduction: The aim of this study was to describe clinical ﬁndings of prolapse of fallopian tube to vaginal vault following abdominal hysterectomy for multiple leiomyomas of uterine and to correlate it with other features.
Case Presentation: A patient with history of leiomyomas and abnormal uterine bleeding was admitted with abdominal pain and scheduled for abdominal hysterectomy. Intra operative inspection showed multiple leiomyomas of uterine. One year after operation of total abdominal hysterectomy, the patient presented with abdominal pain, dyspareunia, and purulent vaginal discharge and therefore, referred to our center for further evaluation. In the vaginal examination, a protruding red mass with ﬁbrotic ﬁmberia was observed. The right fallopian tube (FT) with its ﬁmbria prolapsed to vaginal vault as a granulation tissue was removedfrom vaginal cuﬀ and sent to pathology. The pathologist reported fallopian tube tissue. Post-operative course was uneventful and the patient was discharged on 2nd day of post hysterectomy with good general condition. Six-month follow-up showed abolished purulent discharge. The site of resected vaginal cuﬀ was intact in vaginal examination.
Conclusions: Intra vaginal prolapse of the fallopian tube is a rare sequel of hysterectomy. Clinicians should be aware of this disregarded sequel when dealing with postysterectomy vaginal discharge.
- Sinha P, Johnson AN, Chidamberan-Pillai S. Pelvic tuberculosis: an uncommon gynaecological problem presenting as ovarian mass. BJOG. 2000;107(1):139-40. [DOI:10.1111/j.1471-0528.2000.tb11593.x] [PMID]
- Fan QB, Liu ZF, Lang JH, Sun DW, Leng JH, Zhu L. Fallopian tube prolapse following hysterectomy. Chinese Med Sci J. 2006;21(1):20-3.
- Groutz A, Carmon E, Gat A. Peritoneal tuberculosis versus advanced ovarian cancer: a diagnostic dilemma. Obstet Gynecol. 1998;91(5 Pt2):868. [DOI:10.1016/S0029-7844(97)00667-4]
- Fox R, Kassab A, Sankar A. Ascending peritonitis associated with Fallopian tube prolapse following hysterectomy. J Obstet Gynaecol. 2008;28(4):456. [DOI:10.1080/01443610802164409] [PMID]
- Pozzi M. Hernie de la trompe dans le vagin au niveau d'une cicatrice opératoire d'hysterectomie vaginale. CR Soc Obstet Gynecol Paediatr Paris. 1902;4:255-7.
- Koks CAM, Roumen FJME, Bouckaert PXJM. Prolapse of a fallopian tube through the vaginal introitus following vaginal hysterectomy. J Gynecologic Surgery. 1994;10(4):271-6. [DOI:10.1089/gyn.1994.10.271]
- De Clippel K, Coenen M, Bhal PS, Amso N. Fallopian tube prolapse following abdominal hysterectomy. Aust N Z J Obstet Gynaecol. 2001;41(1):106-8. [DOI:10.1111/j.1479-828X.2001.tb01307.x] [PMID]
- Nistal de Paz F, Herrero Fernandez B, Perez Simon R, Fernandez Perez E, Nistal de Paz C, Ortoll Battle P, et al. Pelvic-peritoneal tuberculosis simulating ovarian carcinoma: report of three cases with elevation of the CA 125. Am J Gastroenterol. 1996;91(8):1660-1.
- Varnholt H, Otis CN, Nucci MR, Johari VP. Fallopian tube prolapse mimicking aggressive angiomyxoma. Int J Gynecol Pathol. 2005;24(3):292-4. [DOI:10.1097/01.pgp.0000159324.44913.b8] [PMID]