title: Effects of horizontal vs vertical vaginal cuff closure techniques on vagina length after vaginal hysterectomy: a prospective randomized study.
abstract: OBJECTIVE
  To compare the effects of horizontal and vertical vaginal cuff closure techniques on vagina length after vaginal hysterectomy.
  
  
  METHODS
  Prospective randomized study (Canadian Task Force classification I).
  
  
  METHODS
  Teaching and research hospital, a tertiary center.
  
  
  METHODS
  Fifty-two women with POP-Q stage 0 or 1 uterine prolapse were randomized into 2 groups using vertical (n = 26) or horizontal (n = 26) vaginal cuff closure.
  
  
  METHODS
  All patients underwent vaginal hysterectomy.
  
  
  RESULTS
  Vagina length in the 2 groups was compared preoperatively, immediately after surgery, and at 6 weeks postoperatively. Mean (SD) preoperative vagina length in the horizontal and vertical groups was similar (7.87 [0.92] cm vs 7.99 [0.78] cm; p = .41). Immediately postoperatively, the vagina was significantly shorter in the horizontal group than in the vertical group (6.61 [0.89] cm vs 7.51 [0.74] cm; p < .001). At 6 weeks postoperatively, the vagina was still significantly shorter in the horizontal group (6.55 [0.89] cm vs 7.42 (0.73) cm; p < .001). The mean difference in vagina length before and after surgery was also significantly higher in the horizontal group than in the vertical group (-1.26 [0.12] cm vs 0.49 [0.11] cm; p < .001).
  
  
  CONCLUSIONS
  Vertical cuff closure during vaginal hysterectomy seems to preserve vagina length better than does horizontal cuff closure.
authors.affiliation: Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey. Electronic address: sabri.cavkaytar@gmail.com.
authors.forename: Sabri
authors.initials: S
authors.lastname: Cavkaytar
authors.affiliation: Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Mahmut Kuntay
authors.initials: MK
authors.lastname: Kokanali
authors.affiliation: Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Hasan Onur
authors.initials: HO
authors.lastname: Topcu
authors.affiliation: Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Orhan Seyfi
authors.initials: OS
authors.lastname: Aksakal
authors.affiliation: Department of Gynecology, Ankara Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Doganay
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D008875:Middle Aged; D009929:Organ Size; D011184:Postoperative Period; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery*; D058106:Wound Closure Techniques; D014945:Wound Healing
keywords: Cuff closure; Horizontal; Vagina length; Vaginal hysterectomy; Vertical