An unexpected bump in the vagina: prolapsed fallopian tube after hysterectomy

Abstract

Fallopian tube prolapse (FTP) after hysterectomy is an uncommon complication accounting to 0.1% of all hysterectomies without salpingectomy. It may present as vaginal discharge, vaginal bleeding and pain in lower abdomen. It is mostly misdiagnosed as granulation tissue due to its appearance. A 27-years old P3A1L2 woman underwent abdominal hysterectomy 8 months back for heavy menstrual bleeding with chronic cervicitis at a private hospital. Following the surgery, she developed complaint of pain in abdomen and vaginal discharge from last 5 months which was profuse and did not subside despite multiple medications. A per speculum examination revealed a mass like fimbrial end of fallopian tube, which was confirmed on biopsy. She was taken for exploratory laparotomy and on identifying the vault one fallopian tube was seen entrapped within it while the other tube was well visualized entirely. The vaginal vault was opened and prolapsed tube was gently separated from it, and bilateral salpingectomy and vault closure was done. The post-operative period was smooth and finally patient was relieved of her troublesome ailment. Post hysterectomy transient vaginal discharge is a common problem, but it is important to perform the basic examination of the patients to find out the cause. A prolonged duration of vaginal discharge should be dealt with more caution and compassion, especially considering rarest of entities like fallopian tube prolapse.