Vaginal length and sexual function after vertical versus horizontal closure of the vaginal cuff after abdominal hysterectomy: a randomised clinical trial.

This randomised clinical trial aimed to evaluate the vaginal length and female sexual function after vertical and horizontal closure of the vaginal cuff after abdominal hysterectomy. The patients were allocated into two groups, vertical closure and horizontal closure groups. The vaginal length was determined using transperineal ultrasound, once preoperative and again 3 months after the operation. Female sexual function was determined using an Arabic validated female sexual function index questionnaire. Both techniques resulted in a significant shortening of the vaginal length (p-value .001). There was a significant improvement in sexual function in the vertical closure group rather than the horizontal closure one. We concluded that there was no significant difference in the vaginal length after vertical or horizontal closure of the vaginal cuff. However, female sexual function improved significantly in the vertical closure group.Trial registration number: PACTR201909573801168.IMPACT STATEMENTWhat is already known on this subject? Conflicting results exist regarding the effect of different techniques of vaginal length closure on vaginal length and sexual function after hysterectomy.What do the results of this study add? There was no significant difference in the vaginal length after vertical or horizontal closure of the vaginal cuff. However, female sexual function improved significantly in the vertical closure group. This study is considered to be the first one to evaluate the correlation between the vaginal length and the female sexual function.What are the implications of these findings for clinical practice and/or further research? The correlation between vaginal length and female sexual function needs to be evaluated in a multicenter study, recruiting larger number of sexually active women.

Evaluation of the severity of striae gravidarum in women with pelvic organ prolapse.

OBJECTIVE: To evaluate the severity of abdominal striae in women presenting with pelvic organ prolapse. STUDY DESIGN: A cross sectional study conducted in the outpatient clinics of obstetrics and gynecology department, Suez Canal University hospitals. We recruited patients over a six months period from January 2019 to June 2019 presenting with symptomatic pelvic organ prolapse (96) and abdominal striae. A control group with no evidence of striae and presenting with symptomatic organ prolapse were recruited also. The degree of prolapse was evaluated using the pelvic organ prolapse quantification system. The evaluation of striae was done using the Davey's scale. RESULTS: Mild, moderate and severe striae affected 20 (20.8 %), 34 (35.4 %), and 42 (43.8 %) women, respectively. Severe striae were noted in women with increased parity (5 ± 2.03). Apical prolapse was more prominent in women with severe striae [42 (100 %)]. Advanced grades of prolapse (grade 3 and 4) were noted in women with severe striae [25 (59.5 %) and 9 (21.5 %) respectively]. Using simple linear regression analysis, abdominal striae was considered a risk factor for the development of POP (P value <0.001); however, when combined with other risk factors in a multivariate model, it had no effect on the development of POP. CONCLUSION: Women with severe abdominal striae were found to have advanced degrees of POP with the apical compartment affected obviously.