Prevention of vaginal prolapse in patients undergoing abdominal hysterectomy

BACKGROUND: In our study we evaluate a personally developed surgical technique that, when used for abdominal hysterectomy, helps prevent posthysterectomy vaginal wall prolapse. METHODS: We have used this modified surgical procedure in 244 consecutive abdominal hysterectomies performed from January 1973 through December 1986, compared with 133 abdominal hysterectomies performed without this new procedure. Patients returned monthly and annually thereafter for follow-up. The longest follow-up period to date is 12 years. RESULTS: Of the 244 patients in our study followed up for 12 years, 234 (95.9%) retained excellent vaginal support. Vaginal wall prolapse occurred in 10 patients (4.1%), and it was asymptomatic prolapse, with the vaginal wall descending less than halfway from the ischial spines to the hymen. CONCLUSIONS: This procedure is an acceptable method to help prevent posthysterectomy vaginal wall prolapse.