Post-hysterectomy fallopian tube prolapse – a diagnostic pitfall

Fallopian Tube Prolapse after Hysterectomy: A Systematic Review

“…Although some of the women were post-menopausal [9,21,26], most of the studies reported patients who were premenopausal [4–8,10–14,16–20,22–24,27–31]. Reasons that may contribute to fallopian tube prolapse are probably multifactorial but the high percentage of premenopausal patients (92.7%) suggest a potential implication of younger age to the occurrence of fallopian herniation.…”

“…Reasons that may contribute to fallopian tube prolapse are probably multifactorial but the high percentage of premenopausal patients (92.7%) suggest a potential implication of younger age to the occurrence of fallopian herniation. In these patients, early resumption of sexual intercourse before complete healing of the vaginal cuff is suggested to be the main important precipitating event [16,26,30]. Over two thirds of the cases reported in the literature occurred after abdominal hysterectomy.…”

Fallopian Tube Prolapse After Total Laparoscopic Hysterectomy

“…[1][2][3][4] Even though tubal prolapse should be suspected with the presence of a red, granular, or polypoid mass in the vaginal cuff after hysterectomy, the differential diagnosis includes granulation tissue related to surgery, malignant lesions, and endometriosis. 1,2 Definitive diagnosis is usually made by histologic confirmation, even though several reports have noted that even histologic confirmation can be difficult at times.…”

“…Even though the incidence of prolapse has been noted to be highest among vaginal hysterectomies, recent evidence has noted an increased trend among laparoscopic hysterectomies. [1][2][3][4][5][6]9,10 It has been proposed that vaginal cuff integrity after laparoscopic hysterectomies may play a role in the incidence of vaginal cuff dehiscence, potentially leading to herniation of fallopian tubes or other abdominal contents through the vaginal defect. Factors predisposing to vaginal cuff dehiscence that may be unique to laparoscopic procedures include energy sources used for cutting and hemostasis and the fast return to normal daily activities among patients undergoing laparoscopic hysterectomies.…”

“…1 Since it was first described, fewer than hundred cases have been reported, and the majority of these have occurred after vaginal hysterectomy. [2][3][4][5][6][7] Surgical management, consisting of excision of all parts of the tube with repair of the vaginal opening, has been described by vaginal, abdominal, and combined approaches. 6 We describe a case where we identified fallopian tube prolapse after a total laparoscopic hysterectomy and subsequently managed the vaginal defect and prolapse by way of the laparoscopic approach.…”