title: A randomized trial comparing methods of vaginal cuff closure at vaginal hysterectomy and the effect on vaginal length.
abstract: OBJECTIVE
  The objective of the study was to compare the effect of horizontal versus vertical closure of the vaginal cuff during vaginal hysterectomy on vaginal length.
  
  
  METHODS
  Forty-three women were randomized to undergo horizontal (n = 23) or vertical (n = 20) vaginal cuff closure during vaginal hysterectomy at a community hospital. The primary outcome of vaginal length before and after surgery was compared by the Student t test and the paired t test.
  
  
  RESULTS
  Preoperatively mean vaginal lengths in the horizontal and vertical groups were statistically similar (7.76 +/- 1.23 cm versus 8.28 +/- 1.39 cm, respectively; P = .21). Postoperatively the groups statistically differed (6.63 +/- 1.02 cm versus 7.93 +/- 1.18 cm, P < .001). The mean change in vaginal length was -1.13 +/- 1.15 cm and -0.35 +/- 0.91 cm, respectively (P = .01). Within-group comparisons revealed a statistical difference between pre- versus postmean vaginal length in the horizontal group (7.76 +/- 1.23 cm versus 6.63 +/- 1.02 cm; P < .001) and no difference within the vertical group (8.28 +/- 1.39 cm versus 7.93 +/- 1.18 cm; P = .11).
  
  
  CONCLUSIONS
  Closing the vaginal cuff vertically is superior to horizontal closure for the purpose of preserving vaginal length.
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Vassallo
authors.forename: Colleen
authors.initials: C
authors.lastname: Culpepper
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Segal
authors.forename: Michael D
authors.initials: MD
authors.lastname: Moen
authors.forename: Michael B
authors.initials: MB
authors.lastname: Noone
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009929:Organ Size; D011184:Postoperative Period; D014621:Vagina / Q000473:pathology* / Q000601:surgery*