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Fallopian tube prolapse after hysterectomy
S M Ramin1, K D Ramin, D L Hemsell
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA.
Background:
Fallopian tube prolapse is reported to most commonly occur after vaginal hysterectomy. Both diagnosis and management have varied, resulting in differing efficacies of treatment.
Methods:
We reviewed the presentation, diagnosis, management, and outcomes of 18 cases of tubal prolapse in 17 women.
Results:
Most cases (65%) occurred after abdominal hysterectomy. The post-hysterectomy course was complicated by cuff cellulitis in three women, an infected cuff hematoma in one, and post-extubation pulmonary edema in one; four were observed for elevated temperature only. At presentation, 44% complained of dyspareunia, 39% vaginal bleeding, 33% vaginal discharge, 28% abdominal pain, and 28% were asymptomatic. Seven women had vaginal excision (one requiring an additional abdominal procedure), three had laparotomy with salpingectomy, and seven (41%) had spontaneous disappearance of prolapsed fallopian tube without treatment.
Conclusions:
In our series, tubal prolapse most commonly occurred after abdominal hysterectomy. Moreover, women with tubal prolapse may be asymptomatic, and observation alone may lead to resolution.