Vaginal length and sexual function after vertical versus horizontal closure of the vaginal cuff after abdominal hysterectomy: a randomised clinical trial

Abstract

This randomised clinical trial aimed to evaluate the vaginal length and female sexual function after vertical and horizontal closure of the vaginal cuff after abdominal hysterectomy. The patients were allocated into two groups, vertical closure and horizontal closure groups. The vaginal length was determined using transperineal ultrasound, once preoperative and again 3 months after the operation. Female sexual function was determined using an Arabic validated female sexual function index questionnaire. Both techniques resulted in a significant shortening of the vaginal length (p-value .001). There was a significant improvement in sexual function in the vertical closure group rather than the horizontal closure one. We concluded that there was no significant difference in the vaginal length after vertical or horizontal closure of the vaginal cuff. However, female sexual function improved significantly in the vertical closure group.

Trial registration number: PACTR201909573801168.

IMPACT STATEMENT

• What is already known on this subject? Conflicting results exist regarding the effect of different techniques of vaginal length closure on vaginal length and sexual function after hysterectomy.

• What do the results of this study add? There was no significant difference in the vaginal length after vertical or horizontal closure of the vaginal cuff. However, female sexual function improved significantly in the vertical closure group. This study is considered to be the first one to evaluate the correlation between the vaginal length and the female sexual function.

• What are the implications of these findings for clinical practice and/or further research? The correlation between vaginal length and female sexual function needs to be evaluated in a multicenter study, recruiting larger number of sexually active women.

Keywords:

• Hysterectomy
• vaginal cuff closure
• vaginal length
• female sexual function

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author’s contributions

AA Ahmed: Protocol formulation, Data collection and management, Data analysis, Manuscript writing/editing.

N Al- Okda: Data collection and management, Data analysis, Manuscript writing/editing.

OT Taha: Data collection and management, Data analysis, Manuscript writing/editing.