Vaginal Stump Characteristics after Total Abdominal Hysterectomy Using Electrosurgery versus Scalpel or Scissors for Vaginal Incision: A Randomized Controlled Trial

To compare the vaginal stump characteristics following total abdominal hysterectomy between two vaginal incision techniques, electrosurgery versus scalpel or scissors. A randomized single-blind controlled trial was performed in 80 patients scheduled to undergo total abdominal hysterectomy for benign conditions. Either sharp instrument (scalpel or scissors) or electrosurgery was used for vaginal incision following standard surgical technique for total abdominal hysterectomy. The main outcome measures were the vaginal stump characteristics determined by the degree of vaginal mucosal approximation and the presence of vaginal granulation at 6-week postoperatively. Six weeks after surgery, the number of patients with incomplete mucosal approximation following electrosurgical technique was 11 (27.5%), as compared to 8 (20%) (p = 0.43) in the scalpel/scissors technique group. The incidences of vaginal granulation in the scalpel/scissors group and electrosurgical group were 10% and 22.5%, respectively. The vaginal stump characteristics at six weeks following total abdominal hysterectomy between two vaginal incision techniques were not statistically significantly different.