The value of posterior colpotomy first technique on the vaginal length during total abdominal hysterectomy.

OBJECTIVE: To investigate the role of posterior colpotomy first technique in preserving vaginal length and support with total abdominal hysterectomy (TAH). MATERIALS AND METHODS: Eighty women candidate for TAH for benign lesion were randomly assigned to either classical technique (40 women) or posterior colpotomy first technique (40 women). The primary outcome parameter was the total vaginal length and shortening measured 3 months after the procedure. RESULTS: The operative time was significantly longer in the posterior colpotomy group compared to classic group (106.28 ± 8.3 vs. 95.18 ± 18.35 min, P < 0.001). Total vaginal shortening was significantly lower in the posterior colpotomy group compared to classic group (0.99 ± 0.3 vs. 2.4 ± 0.8, P < 0.001). The number of women with postoperative dyspareunia was significantly lower in the posterior colpotomy group compared to classic group (4/40 (10%) vs. 8/40 (20%), P = 0.011). The female sexual function index score was significantly higher in the posterior colpotomy group compared to classic group (28.5 ± 2.5 vs. 24.19 ± 1.76, P = 0.038). CONCLUSION: The posterior colpotomy first technique is associated with less shortening of the total vaginal length, less occurrence of dyspareunia, and higher female sexual function index score compared to the classic approach for TAH.