Original ArticleComparison of 2 Methods of Vaginal Cuff Closure at Laparoscopic Hysterectomy and Their Effect on Female Sexual Function and Vaginal Length: A Randomized Clinical Study
Section snippets
Study Design
This was a prospective study with a randomized, double-blind design in a university hospital.
Population and Recruitment
All patients referred to the gynecologic surgery division of the Department of Obstetrics and Gynecology at Istanbul University School of Medicine, Istanbul, Turkey, between November 2014 and 2015 who were scheduled to undergo total laparoscopic hysterectomy because of benign conditions were invited to participate in the study during their first visit to the department.
Inclusion criteria were as
Results
One hundred sixty-five patients were scheduled for laparoscopic hysterectomy for benign gynecologic conditions between November 2014 and 2015. Ninety-five patients gave consent and met the inclusion criteria. Eight patients were excluded from the study postoperatively because their surgery was converted from laparoscopy to laparotomy, either because of intraoperative complications (hemorrhage in 2 patients) or intraoperative conditions (enlarged uterus in 2 patients, inability to tolerate
Discussion
In this study, we tried to evaluate postoperative sexual function and vaginal length between the vaginal route versus the laparoscopic approach in the management of vaginal cuff closure during total laparoscopic hysterectomy in a reproducible and valid manner. Reproducibility and validity were addressed by choosing homogeneous cohort groups of premenopausal patients with benign gynecologic conditions. Vaginal length was measured in a conventional manner, and sexual function was evaluated using
Conclusions
The approach for vaginal cuff closure after hysterectomy usually depends on the preference and the experience of the surgeon. The results of this study indicate that the laparoscopic approach for vaginal cuff closure might be preferable because of better postoperative vaginal length and a shorter total surgery time.
Acknowledgments
We would like to thank David F. Chapman, BSc, for editing the article.
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The authors declare that they have no conflict of interest.
Supported by the Scientific Research Projects Coordination Unit of Istanbul University (grant no. 48890).