scholarly journals Incidence of and risk factors for vaginal cuff dehiscence following total laparoscopic hysterectomy: a monocentric hospital analysis

2021 ◽  
Author(s):  
Julia Caroline Radosa ◽  
Marc Philipp Radosa ◽  
Julia Sarah Maria Zimmermann ◽  
Eva-Marie Braun ◽  
Sebastian Findeklee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Laparoscopic Hysterectomy ◽  
Incidence Rates ◽  
Total Laparoscopic Hysterectomy ◽  
University Hospital ◽  
Vaginal Cuff ◽  
Gynecology And Obstetrics ◽  
Vaginal Cuff Dehiscence

Abstract Purpose Vaginal cuff dehiscence (VCD) is one of the major surgical complications following hysterectomy with data on incidence rates varying largely and studies assessing risk factors being sparse with contradictive results. The aim of this study was to assess the incidence rate of and risk factors for VCD in a homogenous cohort of women treated for benign uterine pathologies via total laparoscopic hysterectomy (TLH) with standardized follow-up. Methods All patients undergoing TLH at the Department of Gynecology and Obstetrics, Saarland University Hospital between November 2010 and February 2019 were retrospectively identified from a prospectively maintained service database. Results VCD occurred in 18 (2.9%) of 617 patients included. In univariate and multivariate analyses, a lower level of surgeon laparoscopic expertise (odds ratio 3.19, 95% confidence interval (CI) 1.0–9.38; p = 0.03) and lower weight of removed uterus (odds ratio 0.99, 95% CI 0.98–0.99; p = 0.02) were associated positively with the risk of VCD. Conclusion In this homogenous cohort undergoing TLH, laparoscopic expertise and uterine weight influenced the risk of postoperative VCD. These findings might help to further reduce the rate of this complication.

scholarly journals Regarding “Trends and Risk Factors for Vaginal Cuff Dehiscence after Laparoscopic Hysterectomy”

2021 ◽  
Author(s):  
Stefano Uccella ◽  
Pier Carlo Zorzato ◽  
Alessandro Favilli ◽  
Mariachiara Bosco ◽  
Massimo P Franchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Hysterectomy ◽  
Vaginal Cuff ◽  
Vaginal Cuff Dehiscence

scholarly journals Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature

2018 ◽  
Vol 7 (12) ◽  
pp. 5204
Author(s):  
Sotirios Kalogeropoulos ◽  
Elpiniki Chronopoulou ◽  
Evangelos Iliopoulos ◽  
Georgios Decavalas
Keyword(s):  
Case Report ◽  
Sexual Activity ◽  
Recovery Period ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Work Place ◽  
High Morbidity ◽  
Vaginal Cuff ◽  
Patient Reported ◽  
Vaginal Cuff Dehiscence

Vaginal cuff dehiscence (VCD) is a serious complication of total laparoscopic hysterectomy (TLH) or trachelectomy with high morbidity, as it can potentially lead to evisceration/bowel ischemia and sepsis. Authors present a case report of vaginal cuff dehiscence after laparoscopic trachelectomy. The patient reported post-coital onset of symptoms. She presented with acute abdomen and required urgent surgical intervention. In this case surgical management was dictated by the clinical manifestation. However, authors argue that conservative management is also an option for some of these patients and the decision regarding the management plan should be personalized according to the clinical presentation and the patient’s expectations. Emphasis should be given to avoid early onset of sexual activity during the immediate recovery period. Compared to women who underwent an abdominal or vaginal hysterectomy, those who had a laparoscopic procedure have less post-operative pain, shorter recovery period and often they are advised to return early to their normal habits and their work place.  It is expected that this group of patients feel well enough to resume sexual activity soon after their procedure. Therefore, our counselling is of paramount importance as it should be highlighted that sexual intercourse is possibly the most common triggering event for VCD which a serious complication with severe morbidity is. The resumption should, therefore, follow medical consultation and be individualized according to co-morbidities which could affect healing, intraoperative findings and evaluation of the whole recovery progress.

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