Prolapse of a Fallopian Tube as a Complication Of Hysterectomy

Tubal prolapse after total laparoscopic hysterectomy

“…Other predisposing factors have previously been proposed and discussed [6,24,36,43,44,49]. These include insufficient preoperative vaginal preparation, difficult surgical procedure, postoperative fever, the formation of haematomas, an open vaginal cuff, low socioeconomic status, use of polyglactin polymer sutures, and use of transvaginal drains or packs.…”

“…This is reasonable, given that not all women with discharge of vault haematomas end up having prolapsed tubes. There is disagreement as to which tube is more likely to prolapse [9,44], and there would not appear to be any anatomical factor favouring one side or the other.…”

Fallopian Tube Prolapse After Total Laparoscopic Hysterectomy

“…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][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.…”

“…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.…”