PERITONEAL CLOSURE AT VAGINAL HYSTERECTOMY - A REASSESSMENT

Objective: To evaluate the clinical outcome of patients who underwent vaginal hysterectomy with or without peritoneal closure. Methods: This study was a randomized trial. Using computer-generated numbers, all p atients undergoing vaginal hysterectomy without oophorectomy were rand omized to either no peritoneal closure (n = 57) or routine peritoneal closure (n = 49). Patients were followed-up for a minimum of 1 year fo r development of complications and postoperative dyspareunia. At 4-6 p ostoperative weeks, the distance between the ovaries and the vaginal c uff was measured by ultrasound. Results: Postoperative complications w ere similar in both groups. The incidence of deep-thrust dyspareunia a t 6 and 12 months was also similar. No statistical differences between the two groups were noted in the ovary to vaginal cuff distances eith er overall or when patients with dyspareunia were considered separatel y. Conclusion: The data in this study do not support the use of reperi tonealization on a routine basis. However, because of a lack of statis tical power, larger studies will be required to confirm this theory.