Vaginal Stump Characteristics after Total Abdominal
Hysterectomy Using Electrosurgery versus Scalpel or
Scissors for Vaginal Incision: A Randomized Controlled Trial
Chayanis Tinsopharat MD*, Krissada Paiwattananupant MD*, Navamol Lekskul MD*, Arb-aroon Lertkhachonsuk MD*,
Nathpong Israngura Na Ayudhya MD*, Chatchai Treetampinich MD*, Sakda Arj-Ong Vallibhakara MD, PhD**
Affiliation :
* Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
Objective : To compare the vaginal stump characteristics following total abdominal hysterectomy between two vaginal
incision techniques, electrosurgery versus scalpel or scissors.
Material and Method: A randomized single-blind controlled trial was performed in 80 patients scheduled to undergo total
abdominal hysterectomy for benign conditions. Either sharp instrument (scalpel or scissors) or electrosurgery was used
for vaginal incision following standard surgical technique for total abdominal hysterectomy. The main outcome measures
were the vaginal stump characteristics determined by the degree of vaginal mucosal approximation and the presence of
vaginal granulation at 6-week postoperatively.
Results : Six weeks after surgery, the number of patients with incomplete mucosal approximation following electrosurgical
technique was 11 (27.5%), as compared to 8 (20%) (p = 0.43) in the scalpel/scissors technique group. The incidences of
vaginal granulation in the scalpel/scissors group and electrosurgical group were 10% and 22.5%, respectively.
Conclusion : The vaginal stump characteristics at six weeks following total abdominal hysterectomy between two vaginal
incision techniques were not statistically significantly different.
Keywords : Colpotomy, Electrosurgery, Granulation, Hysterectomy, Vaginal stump
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