کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3959768 1255466 2009 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Vaginal Vault Dehiscence after Hysterectomy
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
پیش نمایش صفحه اول مقاله
Vaginal Vault Dehiscence after Hysterectomy
چکیده انگلیسی

Study ObjectiveThe purpose of our study was to evaluate factors predisposing vault dehiscence after hysterectomy and its manifestation.DesignCase series and review of the literature (Canadian Task Force classification II-3).SettingMulticenter study.PatientsRetrospective analysis of 16 unpublished cases of vaginal vault dehiscence after total laparoscopic hysterectomy from physicians who participated in the exchange on the topic of vaginal vault dehiscence at the American Association of Gynecologic Laparoscopists Endo Exchange List (group A) and review of 38 reported cases in the literature (group B).InterventionsThe participating physicians were asked to complete a detailed questionnaire related to vault dehiscence. In addition, we performed literature search using the keywords “vault dehiscence,” “vaginal vault dehiscence,” “vault prolapse,” and “hysterectomy,” and conducted the search in MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews.Measurements and Main ResultsWe estimated risk factors and characteristic features for vaginal vault dehiscence. The incidence of vault dehiscence was higher after laparoscopic hysterectomy (1.14%) than after abdominal hysterectomy (0.10%, p <.0001, OR 11.5) and after vaginal hysterectomy (0.14%, p <.001, OR 8.3). The time interval between hysterectomy and occurrence of vault dehiscence in the laparoscopic group (8.4 ± 1.2 weeks) was significantly shorter than in the abdominal hysterectomy (112.7 ± 75.1 weeks, p = .01) and in vaginal hysterectomy (136.5 ± 32.2 weeks, p <.0001) groups, respectively. It appears that sexual intercourse was the main triggering event for vault dehiscence (58.8%). Vaginal bleeding (50%) and vaginal evisceration (48.1%) were the main symptoms.ConclusionOur data suggest that vaginal vault dehiscence is rare but may occur more often after laparoscopic hysterectomy than after other hysterectomy approaches. Whether it is related to the technique of laparoscopic suturing is unclear. Other risk factors such as early resumption of regular activities and sexual intercourse may play a role.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Minimally Invasive Gynecology - Volume 16, Issue 3, May–June 2009, Pages 313–317
نویسندگان
, , , , , , ,