Comparison of 2 Methods of Vaginal Cuff Closure at Laparoscopic Hysterectomy and Their Effect on Female Sexual Function and Vaginal Length: A Randomized Clinical Study

Baştu, Ercan; Yaşa, Cenk; Dural, Özlem; Özgör, Bahar Yüksel; Yılmaz, Gamze; Uğurlucan, Funda Güngör; Buyru, Faruk; Banerjee, Saikat

doi:10.1016/j.jmig.2016.07.007

Cited by 20 publications

(15 citation statements)

References 28 publications

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“…Significant evidence suggests that the rate of vaginal cuff dehiscence (VCD) is higher with intracorporeal closure of the cuff [ 7 - 9 ]. However, laparoscopic intracorporeal closure has been associated with longer postoperative vaginal length and shorter operative time [ 10 ]. The choice between laparoscopic and transvaginal sutures has been thoroughly studied and is outside the scope of this review.…”

Section: Introductionmentioning

confidence: 99%

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Smith¹,

Caceres²

2017

Cureus

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Hysterectomy is one of the most common surgeries performed each year and can be indicated for many gynecologic conditions. The development of minimally invasive surgery has transformed this procedure, resulting in improved outcomes, superior cosmesis, and quicker return to normal function. Vaginal cuff closure is a critical component of hysterectomy, with many variations in surgical technique and materials. This review provides an overview of intracorporeal suturing and knot-tying techniques at the level of a junior resident in obstetrics and gynecology and describes several validated models that have been developed to test resident skill level in vaginal cuff closure. We also provide a review of the literature regarding vaginal cuff closure techniques and suture materials, including knotless barbed sutures. Finally, a brief discussion of single-site surgery, the latest development in minimally invasive hysterectomy, will be provided. We hope to provide a better understanding of vaginal cuff closure for residents in the field of obstetrics and gynecology.

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Section: Introductionmentioning

confidence: 99%

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Smith¹,

Caceres²

2017

Cureus

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“…Ercan suggested that, probably because of the positive effects of less invasive procedures on the patients' self-esteem and quality of life, the procedures may be associated with no visible abdominal scar and a shorter recovery period [24]. Bastu and co-workers studied patients who underwent laparoscopic hysterectomy and those who underwent vaginal cuff closure; the authors found that although sexual function did not differ significantly preoperatively and three months postoperatively, vaginal lengths were significantly longer in the laparoscopic group [25]. In 2014 De La Cruz published a comparison of 38 total vaginal hysterectomies and 46 robotic hysterectomies, both of which were accompanied by pelvic support surgery, with regard to vaginal length and postoperative sexual functions.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Telephone-Based Questionnaire on Quality of Life after Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Total Laparoscopic Hysterectomy

Elessawy

Schneekloth

Maass

et al. 2020

JCM

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Aim: The objective of the study was to evaluate the benefits of robotic-surgery for hysterectomy compared to conventional laparoscopy for benign indications. A specially prepared telephone-based questionnaire was used postoperatively. Method: All women (n = 155) undergoing total laparoscopic hysterectomy for benign indications either by the robotic-assisted procedure (RALH) or conventional laparoscopy (CL) between 1 January 2013 and 31 December 2017 at the Department of the Gynecology, University Hospitals, Campus Kiel, Germany, were eligible for analysis. Intra-operative and postoperative parameters affecting the patients’ quality of life were assessed by a telephone-based questionnaire. The latter addressed postoperative pain, limitations of basic hygiene, daily activity, active pursuit of hobbies, sexual intercourse, and days of sick leave. All patients received the questionnaire by post at least three weeks prior to being contacted on the phone. Results: 78% of the contacted patients responded to the questionnaire; 96% (n = 115) of the patients said they would recommend the operation to other patients. Both groups needed 42 days to resume their regular hobbies. In whole 90.8% (n = 108) were total satisfied with the cosmetic result of the abdominal incision; the numbers in the respective groups were 80% (80% n = 36) in RALH and 97.3% (n = 72) in CL. The difference was significant on the Chi-square test (p = 0.002). 5% (n = 7) were dissatisfied with the scar (13.3%; n = 6) in the RALH group, and 1.4% (n = 1) in CL. In all 1.7 % of patients were dissatisfied with the position of the incisions; the respective numbers were 4.4 % (n = 2) in the RALH group and no patient in the CL group. 33% of patients experienced no limitations in regard of sexual intercourse after the operation. The median number of days taken to resume sexual intercourse after the operation was 56 days in the CL group, and 49 days in the RALH group. Nearly 30% (n = 25) were hesitant to resume intercourse. The median operating time was 145 min in the RALH group, which was significantly longer than the 117 min taken in the CL group (p < 0.001). Conclusions: The RALH procedure was associated with some minor advantages for the patients according to the results, however it does not have major significant advantages, especially in regard of early restoration of sexual function, while the CL shows shorter operating times and similar limitation. Postoperative counseling of patients should be aligned to their fears and expectations in regard of sexual function.

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“…Bastu et al [7] randomized patients who underwent laparoscopic hysterectomy for the route of vaginal cuff closure where either laparoscopic or vaginal route was preferred. They reported that although female sexual functions did not differ significantly pre and three months postoperatively, vaginal lengths were significantly longer in laparoscopic route group.…”

Section: Discussionmentioning

confidence: 99%

“…In a study searching the effect of horizontal and vertical vaginal cuff closure following vaginal hysterectomy for pelvic organ prolapsus it was demonstrated that there was no difference in female sexuality between two closure techniques [6]. On the other hand, another study investigating the effect of vaginal cuff closure technique after laparoscopic hysterectomy showed improvement in female sexuality through laparoscopic approach [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus vaginal cuff closure in laparoscopic hysterectomy: does it affect female sexuality?

et al. 2019

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Objectives:To investigate the effect of vaginal cuff closure technique in laparoscopic hysterectomy on vaginal length and female sexual functions. Material and methods:This study was conducted at a tertiary research hospital. Women who underwent laparoscopic hysterectomy were included and classified according to vaginal cuff closure technique as laparoscopic (n = 75) and vaginal route (n = 25). Vaginal lengths were measured preoperatively and at 6th month postoperatively. Golombok-Rust Inventory of Sexual Satisfaction (GRISS) was used to evaluate female sexual functions. SPSS was used for statistical analysis and the level of significance was p = 0.05. Results:Preoperative GRISS scores and vaginal lengths were similar in two groups. The shortening of vaginal length and the worsening of GRISS scores were more prominent in vaginal cuff closure group (p = 0.002, p < 0.001). The alteration in vaginal length was positively correlated with the alteration in GRISS score in vaginal and laparoscopic route groups (r = 0.800, p < 0.001; r = 0.680, p < 0.001). The risk of female sexual dysfunction increases 69.88 fold for each 1 cm shortening of vaginal length (p = 0.039). Discriminative value of postoperative vaginal length for female sexual dysfunction in patients who underwent laparoscopic hysterectomy was investigated and a cut-off value of 7.4 cm (p < 0.001) was found. Conclusions:Laparoscopic route instead of vaginal route in laparoscopic hysterectomy is preferable to preserve a better vaginal length, which may be an important factor for female sexual functions.

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Comparison of 2 Methods of Vaginal Cuff Closure at Laparoscopic Hysterectomy and Their Effect on Female Sexual Function and Vaginal Length: A Randomized Clinical Study

Cited by 20 publications

References 28 publications

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Vaginal Cuff Closure in Minimally Invasive Hysterectomy: A Review of Training, Techniques, and Materials

Postoperative Telephone-Based Questionnaire on Quality of Life after Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Total Laparoscopic Hysterectomy

Laparoscopic versus vaginal cuff closure in laparoscopic hysterectomy: does it affect female sexuality?

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