Balci technique for suspending vaginal vault at vaginal hysterectomy with reduced risk of vaginal vault prolapse

Abstract

Aim: The aim of this study was to evaluate the efficacy of a new technique of suspending the vaginal vault at vaginal hysterectomy (VH) for total uterine prolapse. Material and Methods: This prospective study included 65 patients (group 1) in whom VH was performed using the new technique and 110 patients (group 2) in whom VH was performed using the traditional method. Both groups were followed up for 4 years. The incidences of vaginal vault prolapse (VVP), total vaginal length (TVL) (location of vaginal cuff), intraoperative and postoperative complications and sexual function were compared. Results: There were no statistically significant differences between the two groups regarding age, parity, body mass index (BMI), blood loss, intraoperative and postoperative complications, and sexual function. One (1.5%) patient had VVP in group 1, whereas 12 (10.9%) patients had VVP in group 2. TVL in group 1 was 8.9 ± 1.2 cm while in group 2 it was 5.9 ± 0.8 cm. The operation times were 57 ± 5 min and 76 ± 9 min in group 1 and group 2, respectively. There was a statistically significant difference between the two groups regarding VVP (P = 0.022), TVL (P < 0.001) and operation time (P < 0.001). The two groups were also compared regarding anterior and posterior prolapse after 4 years: group 1 had less anterior and posterior prolapse (stage II or more) than group 2 (P = 0.041, P = 0.047), respectively. Conclusion: In this new technique, compared to the traditional technique, there was a lower incidence of VVP, greater TVL was achieved and the duration of the operation was shorter.