Lesions of the vaginal vault following complete hysterectomy

Abstract

Benign and recurrent malignant lesions occur in the vaginal scar line following complete hysterectomy. The incidence, with the exception of granulation tissue, is low.Eight cases are reported, two with benign lesions and six with recurrent malignant lesions in the vaginal scar.The appearance of granulation tissue varies; it may be an elevated red nodule, or it may be similar to an ulcer of the vaginal mucous membrane. In like manner malignant recurrence in the vaginal scar may assume one of the above forms. The importance of correct diagnosis is emphasized.Prolapse of a portion of the oviduct or some portion of the bowel is observed only after vaginal hysterectomy and not after abdominal hysterectomy. Oviduct prolapse is not a serious complication and requires only the correct diagnosis to institute the simple treatment necessary. In contradistinction, prolapse of bowel through the vaginal wound is serious and requires more radical treatment.Malignant lesions may recur in the vaginal scar by implantation of viable cells, by direct extension, or by lymphatic or vascular extension.Biopsy is a necessary procedure in the differential diagnosis of these various lesions.