title: Comparison of 2 Methods of Vaginal Cuff Closure at Laparoscopic Hysterectomy and Their Effect on Female Sexual Function and Vaginal Length: A Randomized Clinical Study.
abstract: To compare the effects of the laparoscopic approach versus the vaginal route for the management of vaginal cuff closure during total laparoscopic hysterectomy on female sexual function in premenopausal patients with benign gynecologic conditions.
  
  
  
  A prospective study with a randomized, double-blind design (Canadian Task Force Classification I).
  
  
  
  A university hospital.
  
  
  
  Patients who were scheduled to have total laparoscopic hysterectomy because of benign conditions.
  
  
  
  Patients were randomized to vaginal cuff closure via the vaginal route versus the laparoscopic approach. The study included a total of 70 patients; 34 underwent the laparoscopic approach in the management of vaginal cuff closure, and 36 underwent the vaginal route.
  
  
  
  Female sexual function and vaginal length were measured. The duration of total surgery was significantly shorter in the laparoscopic approach group compared with the vaginal route group (112.2 ± 36.5 vs 122.7 ± 53.6, p < .05). The total Female Sexual Function Index scores preoperatively and 3 months postoperatively were similar between the laparoscopic approach and vaginal route groups (all p > .05). Vaginal lengths 3 months postoperatively were significantly longer in the laparoscopic approach group compared with the vaginal route group (8.39 ± 0.90 vs 7.34 ± 1.17, p < .05). The duration of cuff closure was significantly shorter in the vaginal route group compared with the laparoscopic approach group (8.92 ± 2.23 vs 7.51 ± 2.5, p < .05). Preoperative vaginal lengths were significantly longer in comparison with 3 months postoperatively both in the laparoscopic approach and the vaginal route groups (all p < .05). The preoperative total Female Sexual Function Index scores were significantly higher in comparison with 3 months postoperatively both in the laparoscopic approach and the vaginal route groups (all p < .05).
  
  
  
  The results of this study indicate that the laparoscopic approach for vaginal cuff closure might be preferable because of better postoperative vaginal length and a shorter duration of total surgery time.
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey; School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK. Electronic address: ercan.bastu@istanbul.edu.tr.
authors.forename: Ercan
authors.initials: E
authors.lastname: Bastu
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Yasa
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Dural
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Bahar Yuksel
authors.initials: BY
authors.lastname: Ozgor
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Yilmaz
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Gungor Ugurlucan
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Buyru
authors.affiliation: PostGraduate Medical School, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
authors.forename: Saikat
authors.initials: S
authors.lastname: Banerjee
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007045:Hysterectomy, Vaginal / Q000379:methods; D010535:Laparoscopy; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012725:Sexual Behavior / Q000502:physiology*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014621:Vagina / Q000033:anatomy & histology* / Q000601:surgery
keywords: Female sexual function; Laparoscopic hysterectomy; Vaginal cuff closure