Factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.

Abstract

Background: Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy. However, vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far, there are limited studies on vaginal cuff dehiscence after a total hysterectomy.

Aim: To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.

Methods: This study retrospectively, univariately, and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People's Hospital from January 2015 to December 2021. Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.

Results: Among 1459 cases with laparoscopic hysterectomy, 9 reported vaginal cuff dehiscence postoperatively, with an incidence of 0.617%. Univariate logistic regression analysis revealed that preoperative hemoglobin value [odds ratio (OR) = 5.12, P = 0.016], vaginal cuff suture method (OR = 0.26, P = 0.048), and postoperative first sexual lifetime (OR = 15.86, P = 0.002) were associated with vaginal cuff dehiscence following laparoscopic hysterectomy. Multivariate logistic regression analysis revealed that preoperative hemoglobin value of < 90 g/L (OR = 5.17, P = 0.015) and time interval between postoperative first sexual life and operation of < 3 months (OR = 54.00, P = 0.004) are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.

Conclusion: Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.