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Updated: May 31, 2026
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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Vaginal cuff dehiscence after hysterectomy: a multicenter retrospective study
Marcello Ceccaroni1, Roberto Berretta, Mario Malzoni
1Gynecologic Oncology Division, International School of Surgical Anatomy, Sacred Heart Hospital, Negrar, Verona, Italy.
Summary
Vaginal evisceration after hysterectomy is a rare complication. Laparoscopic hysterectomy showed a higher dehiscence rate, though repair outcomes were similar across surgical methods. Healing is crucial to prevent this event.
Area of Science:
- Gynecological Surgery
- Surgical Complications
- Patient Outcomes
Background:
- Vaginal cuff dehiscence is a rare but serious complication following hysterectomy.
- Understanding the incidence and risk factors associated with different hysterectomy approaches is crucial for patient safety.
Purpose of the Study:
- To estimate the incidence of vaginal cuff dehiscence across abdominal, vaginal, and laparoscopic hysterectomy methods.
- To identify potential trigger events and compare repair outcomes.
Main Methods:
- Retrospective analysis of 8635 patients undergoing hysterectomy.
- Comparison of dehiscence rates between abdominal, vaginal, and laparoscopic approaches.
- Statistical analysis including ANOVA, Chi-square tests, and Pearson's correlation.
Main Results:
- A total of 34 patients (0.39%) experienced vaginal evisceration.
- Laparoscopic hysterectomy was associated with a significantly higher incidence of dehiscence (p<0.05).
- No significant difference in dehiscence was observed between closed and unclosed vaginal cuff techniques.
Conclusions:
- Vaginal evisceration is an infrequent complication of hysterectomy.
- Sexual activity before complete cuff healing is a trigger in younger patients; spontaneous evisceration occurs in elderly patients.
- Both vaginal and laparoscopic surgical repairs yield similar outcomes.
