Risk factors:
(1) previous pelvic surgery
(1a) hysterectomy (most cases) - may be vaginal or abdominal
(1b) laparoscopic surgery without hysterectomy
(2) vaginoperitoneal fistula
(3) poor physical condition of the patient
(4) problem with surgical technique
(5) postoperative vaginal or pelvic infection
(6) use of intraperitoneal vaginal drains
(7) failure to close the vaginal cuff
(8) postoperative pelvic hematoma
Clinical features:
(1) asymptomatic
(2) vaginal bleeding or leucorrhea
(3) dyspareunia
(4) chronic pelvic pain
Preventive measures at the time of the previous surgery:
(1) salpingectomy
(2) fixing the tubes to the pelvic wall
(3) complete peritonealisation while closing
Differential diagnosis:
(1) primary or metastatic tumor
(2) mesonephric or paramesonephric duct cyst
(3) endometriosis
(4) vaginal adenosis
(5) granulation tissue
