title: Vaginal cuff closure technique and the risk for infected pelvic hematoma after vaginal hysterectomy.
abstract: OBJECTIVE
  Infected pelvic hematoma is a relatively common complication of vaginal hysterectomy, manifesting with postoperative pain and fever which often necessitate surgical drainage. We aimed to assess the effect of the surgical technique for vaginal cuff closure on the incidence of this complication.
  
  
  METHODS
  Until March 31, 2010, our surgical protocol for vaginal hysterectomy included complete vaginal cuff closure. After this date, all surgeries were performed using another technique, by which a patent tract was left at the vaginal cuff for drainage of blood, secretions and debris. We reviewed medical records of all women who underwent vaginal hysterectomy for pelvic organ prolapse in our institution between January 2006 and November 2015, including demographic, clinical and surgical data. We compared the incidence of postoperative infected pelvic hematomas before and after March 31, 2010.
  
  
  RESULTS
  We identified 325 women who underwent vaginal hysterectomy during the first time period (group I) and 243 women who underwent this procedure during the second time period (group II). While demographic and clinical data were not significantly different between the two groups, the incidence of infected pelvic hematomas necessitating hospitalization was significantly lower in group II (3.8% vs. 13.5%, p<0.0001).
  
  
  CONCLUSIONS
  A significant reduction in the incidence of infected pelvic hematoma following vaginal hysterectomy was noted using a surgical technique that allows for drainage of blood and debris through the vaginal cuff.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel. Electronic address: idofeferkorn@gmail.com.
authors.forename: Ido
authors.initials: I
authors.lastname: Feferkorn
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Meirav
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Yakir
authors.initials: Y
authors.lastname: Segev
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Zilberlicht
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Auslender
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Carmel Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Abramov
mesh_terms: D000368:Aged; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology*; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D010388:Pelvis / Q000601:surgery; D012307:Risk Factors; D058106:Wound Closure Techniques / Q000009:adverse effects*
keywords: Pelvic hematoma; Vaginal cuff closure; Vaginal hysterectomy