TY - JOUR
T1 - Abdominal hysterectomy with or without angle stitch
T2 - correlation with subsequent vaginal vault prolapse
AU - Rahn, David D.
AU - Stone, Rebecca J.
AU - Vu, Andy K.
AU - White, Amanda B.
AU - Wai, Clifford Y.
PY - 2008/12
Y1 - 2008/12
N2 - Objective: The objective of the study was to assess whether cardinal-uterosacral ligament lateral vaginal cuff angle stitches at the time of total hysterectomy may assist in preventing subsequent apical vault prolapse. Study Design: Total hysterectomies without cuff angle stitches were performed in 7 unembalmed cadavers. Successive hanging weights of 1, 2, 3, and 4 kg were loaded against the vaginal cuff and distances moved were recorded. The same process was repeated after tying bilateral angle stitches. Results: Average distances pulled with 1, 2, 3, and 4 kg of traction against the cuff without angle stitches were 14.6 ± 1.4, 19.1 ± 1.7, 23.1 ± 2.3, and 27.6 ± 2.0 mm, respectively. After completing angle sutures, these distances were 13.1 ±1.1, 17.3 ± 1.5, 20.9 ± 1.9, and 25.1 ± 2.6 mm, respectively (P = .026). Conclusion: Methodical incorporation of the cardinal-uterosacral ligaments into the vaginal cuff margins at time of total abdominal hysterectomy may help minimize subsequent apical vault prolapse.
AB - Objective: The objective of the study was to assess whether cardinal-uterosacral ligament lateral vaginal cuff angle stitches at the time of total hysterectomy may assist in preventing subsequent apical vault prolapse. Study Design: Total hysterectomies without cuff angle stitches were performed in 7 unembalmed cadavers. Successive hanging weights of 1, 2, 3, and 4 kg were loaded against the vaginal cuff and distances moved were recorded. The same process was repeated after tying bilateral angle stitches. Results: Average distances pulled with 1, 2, 3, and 4 kg of traction against the cuff without angle stitches were 14.6 ± 1.4, 19.1 ± 1.7, 23.1 ± 2.3, and 27.6 ± 2.0 mm, respectively. After completing angle sutures, these distances were 13.1 ±1.1, 17.3 ± 1.5, 20.9 ± 1.9, and 25.1 ± 2.6 mm, respectively (P = .026). Conclusion: Methodical incorporation of the cardinal-uterosacral ligaments into the vaginal cuff margins at time of total abdominal hysterectomy may help minimize subsequent apical vault prolapse.
KW - anatomy
KW - apical support
KW - cardinal ligament
KW - uterosacral ligament
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U2 - 10.1016/j.ajog.2008.07.051
DO - 10.1016/j.ajog.2008.07.051
M3 - Article
C2 - 18845281
AN - SCOPUS:57149130251
SN - 0002-9378
VL - 199
SP - 669.e1-669.e4
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 6
ER -