Candiani G B, Candiani M
Second Department of Obstetrics and Gynecology, University of Milan, Italy.
J Reprod Med. 1996 Dec;41(12):915-20.
Tubal herniation as a complication of hysterectomy is a rare phenomenon, markedly more frequent after vaginal hysterectomy. With the increasing use of the vaginal route, the ratio between tubal herniation after vaginal versus abdominal hysterectomy may exceed 3:1.
We report two cases of tubal herniation into the vagina, one after vaginal hysterectomy and the other after total abdominal hysterectomy, in two patients, aged 36 and 37 years.
A tubal prolapse in the vagina may be considered a hernia and occurs only if a communication exists between the peritoneal cavity and vaginal canal. It can be an early or late prolapse. Symptoms consist almost exclusively of persistent blood loss and/or leukorrhea, dyspareunia and chronic pelvic pain. Whether the abdominal or vaginal approach should be used in surgical correction of prolapsed tubes must be decided in each case according to the patient's individual characteristics. Both histologic pictures described merit careful attention, distinguishing between the terminal tubal segment and the more cranial tract (above the vaginal strangulation).
输卵管疝作为子宫切除术后的一种并发症较为罕见，在阴道子宫切除术后更为常见。随着阴道途径使用的增加，阴道子宫切除术后与腹式子宫切除术后输卵管疝的发生率之比可能超过3:1。
我们报告了两例输卵管疝入阴道的病例，一例发生在阴道子宫切除术后，另一例发生在全腹式子宫切除术后，患者分别为36岁和37岁。
阴道内输卵管脱垂可被视为一种疝，仅在腹腔与阴道管之间存在连通时才会发生。它可以是早期或晚期脱垂。症状几乎仅包括持续失血和/或白带、性交困难及慢性盆腔疼痛。对于脱垂输卵管的手术矫正应采用腹式还是阴道途径，必须根据每个患者的个体特征来决定。所描述的两种组织学表现均值得仔细关注，需区分输卵管末端节段和更靠上的管道（阴道绞窄上方）。
