Risk factors for vaginal cuff dehiscence after total laparoscopic hysterectomy: A retrospective study

Vaginal cuff dehiscence is a serious complication following hysterectomy and is more frequent after the laparoscopic compared with the abdominal or vaginal route. The objective of this study is to investigate the risk factors for vaginal cuff dehiscence after total laparoscopic hysterectomy.

This retrospective, single-center study included patients who underwent total laparoscopic hysterectomy between January 2015 and December 2020 at the Rouen University Hospital. Two groups of patients were compared based on the presence or absence of vaginal cuff dehiscence. To identify factors independently associated with vaginal cuff dehiscence, we performed a multivariate analysis.

During the study period, 557 patients were included. The rate of vaginal cuff dehiscence was 4% (23 patients). Age under 40 years and BMI under 30 kg/m² were independent risk factors of vaginal cuff dehiscence following total laparoscopic hysterectomy (OR = 4.77, 95% CI [1.74 - 13.85] for age, OR = 5.68, 95% CI [1.22 - 51.08] for BMI). The use of curative anticoagulation (OR = 15.35, 95% CI [2.40 - 81.50]) and surgical site infection (OR = 9.89, 95% CI [2.84 - 32.45]) were also associated with vaginal cuff dehiscence.

Age under 40 years, BMI under 30 kg/m², curative anticoagulation and surgical site infection appear to be independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.