Original articleIncidence and patient characteristics of vaginal cuff dehiscence after different modes of hysterectomies
Section snippets
Materials and methods
All women who underwent any type of hysterectomy or vaginal dehiscence repair at Magee-Womens Hospital (MWH) from January 2000 through March 2006 were identified by use of pertinent diagnostic codes and procedure codes. The medical records of the patients with dehiscence were reviewed to ensure that only those patients who had a vaginal cuff dehiscence as a complication of a hysterectomy were included in the study. Both the accuracy of the diagnosis and the location of the original hysterectomy
Results
A total of 7286 hysterectomies via all surgical modalities was performed at MWH from January 2000 through March 2006; 7039 of these were total hysterectomies, 244 were supracervical hysterectomies (excluded), and 3 were hysterectomies that were not classified. An average of 1126 total hysterectomies were performed annually, ranging from 1065 to 1143 total hysterectomies per year (Table 1). During the same time period, a total of 12 vaginal cuff dehiscences were repaired at MWH. Ten of these
Discussion
Vaginal cuff dehiscence after hysterectomy is a rare event. There are few published reports of the incidence of vaginal dehiscence after hysterectomy. Croak et al1 report a 0.032% incidence of vaginal evisceration, but this incidence includes all pelvic operations. We were specifically interested in the incidence of vaginal dehiscence after hysterectomy. Ramirez and Klemer10 provide a thorough review of the literature regarding vaginal eviscerations after hysterectomy but fail to calculate an
Conclusions
Total laparoscopic hysterectomies appear to have a statistically significant increased risk of vaginal cuff dehiscence compared with other modes of hysterectomy. We recommend laparoscopic hysterectomies over abdominal hysterectomies because of advantages such as less blood loss, fewer infections or fevers, shorter hospital stay and recovery time, earlier resumption of baseline activities,11 faster return to work, less postoperative pain,12, 13, 14 decreased pain medication requirements, and
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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.