[Clinical analysis of fallopian tube prolapse after hysterectomy].

OBJECTIVE

To investigate the clinical diagnosis, treatment and prevention of fallopian tube prolapse (FTP) after hysterectomy.

METHODS

A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital, including 6229 cases of trans-abdominal hysterectomy (TAH), 780 cases of transvaginal hysterectomy (TVH), and 940 cases of laparoscopic assisted vaginal hysterectomy (LAVH). Nine cases (including 1 case from other hospital) of FTP after hysterectomy were analyzed retrospectively for their symptoms, diagnosis and treatment. All of them were diagnosed according to the results of histology and follow-up.

RESULTS

The overall incidence of FTP after hysterectomy was 0.11% (9/7949). Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229), after vaginal hysterectomy 0.51% (4/780), and after laparoscopic assisted vaginal hysterectomy 0 (0/940). There were no symptoms in 3 cases, but the other 6 cases had symptoms. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases. All of them were excised vaginally and cauterized. The results were confirmed by histological examination. No recurrent cases were reported in follow up.

CONCLUSIONS

FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment. Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.