Incidence of Vaginal Cuff Dehiscence after Different Modes of Hysterectomy: A Follow-Up Study to a Single Institution's Experience

Abstract

Study Objective: To update the incidence of vaginal cuff dehiscence after varying modes of hysterectomy, as well as to identify surgical and patient characteristics associated with cuff dehiscence.Design: Retrospective review.Setting: Large, urban, university teaching hospital.Patients: All women who underwent hysterectomy and had a vaginal cuff dehiscence repair from January 2006 until December 2009 at Magee-Womens Hospital (MWH) were analyzed, compared and combined with the prior data set (from 2000-2005) for a 10-year analysis.Intervention: Repair of vaginal cuff dehiscence.Tabled 1Incidence of vaginal cuff dehiscence (#dehiscences/#total hysterectomies)2000-20052006-20092000-2009All total hysts0.13 (9/6720)0.39 (19/4910)0.24 (28/11,630)TAH0.00 (0/4506)0.38 (11/2886)0.15 (11/7392)TVH0.06 (1/1617)0.11 (1/917)0.08 (2/2534)LH1.34 (8/597)0.63 (7/1107)0.88 (15/1704)Breakdown of LH2004-20052006-20092004-2009 LAVH0.00 (0/131)0.46 (2/432)0.36 (2/563) TLH4.08 (8/196)0.75 (5/668)1.50 (13/864) RLH0.00 (0/0)0.00 (0/7)0.00 (0/7)Note: LAVH and TLH were analyzed separately from 2004-2009; TAH=Total Abdominal Hysterectomy, TVH=Total Vaginal Hysterectomy, LH=Laparoscopic Hysterectomy, LAVH=Laparoscopic-Assisted Vaginal Hysterectomy, TLH=Total Laparoscopic Hysterectomy, RLH=Robotic-Assisted Laparoscopic Hysterectomy Open table in a new tab Conclusion: This study is the first to provide an updated incidence of vaginal cuff dehiscence after varying modes of hysterectomy. While TLH has historically been reported to have an increased risk of dehiscence, our updated analysis suggests the incidence of cuff dehiscence after TLH is not nearly as high as previously published. Study Objective: To update the incidence of vaginal cuff dehiscence after varying modes of hysterectomy, as well as to identify surgical and patient characteristics associated with cuff dehiscence. Design: Retrospective review. Setting: Large, urban, university teaching hospital. Patients: All women who underwent hysterectomy and had a vaginal cuff dehiscence repair from January 2006 until December 2009 at Magee-Womens Hospital (MWH) were analyzed, compared and combined with the prior data set (from 2000-2005) for a 10-year analysis. Intervention: Repair of vaginal cuff dehiscence. Note: LAVH and TLH were analyzed separately from 2004-2009; TAH=Total Abdominal Hysterectomy, TVH=Total Vaginal Hysterectomy, LH=Laparoscopic Hysterectomy, LAVH=Laparoscopic-Assisted Vaginal Hysterectomy, TLH=Total Laparoscopic Hysterectomy, RLH=Robotic-Assisted Laparoscopic Hysterectomy Conclusion: This study is the first to provide an updated incidence of vaginal cuff dehiscence after varying modes of hysterectomy. While TLH has historically been reported to have an increased risk of dehiscence, our updated analysis suggests the incidence of cuff dehiscence after TLH is not nearly as high as previously published.