Does hysterectomy without adnexectomy in patients with prior tubal interruption increase the risk of subsequent hydrosalpinx

OBJECTIVE: Our purpose was to examine the hypothesis that hysterectomy without adnexectomy after tubal interruption is associated with the development of hydrosalpinx. STUDY DESIGN: In this case-control study, patients with a pathologic diagnosis of hydrosalpinx were compared with a group of patients undergoing adnexectomy without a hydrosalpinx. The incidence of prior tubal interruption followed by hysterectomy in the two groups was compared. RESULTS: There was a statistically significant association between the development of hydrosalpinx and a history of hysterectomy after tubal interruption. Nine of 38 cases and 2 of 45 controls had a history of tubal interruption (odds ratio 6.67, P =.019). CONCLUSIONS: Patients undergoing hysterectomy who have had a tubal interruption may be at risk for the development of hydrosalpinx because this combination of procedures results in a segment of tube that is blocked at both ends. If further study bears out this association, consideration should be given to performing salpingectomy at the time of hysterectomy even if the ovaries are being left behind

Granulomatosis with Polyangiitis-Mimicking Advanced Gynecological Cancer: A Case Report and Systematic Review of the Literature

(1) Background: Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitis that mimics gynecologic cancer. In GPA patients, the genitourinary system is affected in <1%. The objective of the study was to provide a systematic review of the literature of GPA patients with gynecological involvement. (2) Methods: PubMed and Embase were searched from inception to July 2021 for GPA patients with gynecological involvement Medical Subject Headings (MeSH) and free-text terms. Exclusion criteria were other language, review articles, pregnancy, fertility, or male patients. Data were extracted on clinical evolution, symptoms, examinations findings, diagnosis delay, treatment, outcome, patient status, and follow-up. (3) Results: Seventeen studies included data from patients with GPA and primary or relapsed gynecological involvement. 68% of the authors of this review thought the patient had cancer. The main gynecological symptom is bleeding, but exclusive gynecologic symptomatology is rare (ENT: 63%, lungs: 44%, kidneys-urinary tract: 53%). GPA could affect all areas of the genital tract, but the most frequent location is the uterine cervix. Medical treatment for GPA is effective. (4) Conclusions: GPA of the female genital tract must be considered when biopsies of an ulcerated malignant-appearing cervical or vaginal mass are negative for malignancy even when they are unspecific. Rheumatology consultation is indicated

Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities

Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation. These fistulas can be a challenging condition to treat. Although most fistulas can be treated with surgical repair, for those patients who are not operative candidates, limited options remain. As minimally-invasive interventional techniques have evolved, the possibility of fistula occlusion has enriched the therapeutic armamentarium for the treatment of these complex patients. In order to offer optimal treatment options to these patients, it is important to understand the imaging and anatomical features which may appropriately guide the surgeon and/or interventional radiologist during pre-procedural planning