Vaginal Cuff Dehiscence in a Series of 12,398 Hysterectomies

Abstract

To investigate the risk of vaginal cuff dehiscence after different routes of hysterectomy and methods of cuff closure. A multi-institutional analysis of 12,398 patients who underwent hysterectomy for both benign and malignant disease between 1994 and 2008 was performed. We analyzed how different routes of hysterectomy and approaches to cuff suture may influence the risk of development of vaginal dehiscence. Women who had total laparoscopic (n=3,573), abdominal (n=4,291), and vaginal (n=4,534) hysterectomies experienced 23 (0.64%), 9 (0.2%), and 6 (0.13%) cases of vaginal cuff dehiscence, respectively. Total laparoscopic hysterectomy was associated with a higher incidence of cuff separations, compared with abdominal hysterectomy (0.64% compared with 0.21%, P=.003) and vaginal hysterectomy (0.64% compared with 0.13%, PCONCLUSION:Transvaginal suturing appears to reduce the risk of vaginal dehiscence after total laparoscopic hysterectomy.LEVEL OF EVIDENCE:II