Vaginal cuff dehiscence after hysterectomy.
OBJECTIVE
To determine the incidence of vaginal cuff dehiscence (VCD) among women undergoing hysterectomy according to clinico-surgical factors including surgical route, and to describe patient characteristics associated with VCD.


METHODS
In a retrospective study, the medical records of all women who underwent hysterectomy between January 2005 and March 2011 at a university teaching hospital in Seoul, Republic of Korea, were reviewed. The incidence of VCD was determined in relation to the following factors: patient age, hysterectomy route, indication for hysterectomy, and extent of resection (either simple or radical hysterectomy).


RESULTS
Among 9973 hysterectomies, 37 (0.37%) cases of VCD were identified. The incidence of VCD was significantly higher after abdominal hysterectomy (0.6%) than after laparoscopic (0.2%) or vaginal (0.4%) hysterectomy (P=0.016). Compared with laparoscopic approaches, abdominal hysterectomy was associated with a higher risk of VCD (odds ratio, 2.735; 95% confidence interval, 1.380-5.420). However, there was no significant difference in the incidence of VCD according to surgical indication or extent of resection.


CONCLUSION
Laparoscopic hysterectomy was found to be associated with a lower risk of VCD compared with abdominal hysterectomy. The lower risk is probably related to the different techniques used for colpotomy and cuff closure.
['Koo|Yu-Jin|YJ|', 'Kim|Dae-Yeon|DY|', 'Kim|Jong-Hyeok|JH|', 'Kim|Yong-Man|YM|', 'Kim|Young-Tak|YT|', 'Nam|Joo-Hyun|JH|']
D000328:Adult D000367:Age Factors D020884:Colpotomy D005260:Female D006785:Hospitals, University D006801:Humans D007044:Hysterectomy D007045:Hysterectomy, Vaginal D015994:Incidence D010535:Laparoscopy D008875:Middle Aged D056910:Republic of Korea D012189:Retrospective Studies D012307:Risk Factors D013529:Surgical Wound Dehiscence D014623:Vaginal Diseases
Hysterectomy Complication Laparoscopy Vault dehiscence