Horizontal versus vertical vaginal cuff closure after vaginal hysterectomy

Investigation of the Effect of Horizontal and Vertical Vaginal Cuff Closure on Postoperative Total Vaginal Length in Patients Undergoing Vaginal Hysterectomy and Lateral Suspension

This study will test whether horizontal or vertical vaginal cuff closure better preserves vaginal length in people having vaginal hysterectomy with lateral suspension for stage 3–4 uterine prolapse.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 62 (estimated)
• Ages: 35 Years to 65 Years
• Sex: Female
• Sponsor: Gaziosmanpasa Research and Education Hospital (other gov)
• Locations: 1 site (Istanbul)
• Trial ID: NCT07067645 on ClinicalTrials.gov

What this trial studies

This prospective, randomized study assigns eligible patients undergoing vaginal hysterectomy with lateral suspension to either horizontal or vertical vaginal cuff closure. All procedures are performed by the same surgical team to reduce technique variability, and total vaginal length is measured before and after surgery using standardized pelvic examinations. Secondary outcomes include patient-reported symptoms such as sensation of vaginal shortening and sexual function, operative time, intraoperative complications, and early postoperative recovery. The goal is to identify which closure orientation more effectively preserves vaginal length and informs surgical technique choices.

Who should consider this trial

Good fit: Adults with stage 3–4 uterine prolapse who are scheduled for vaginal hysterectomy with lateral suspension and who can consent to randomization and follow-up are the intended participants.

Not a fit: Patients with prior suspension surgeries, hysterectomy for malignancy, prior pelvic radiotherapy, severe vaginal atrophy, or inability to comply with follow-up are not expected to benefit from this enrollment.

Why it matters

Potential benefit: If one closure orientation preserves vaginal length better, adopting that technique could improve pelvic support, sexual function, and overall postoperative satisfaction for affected patients.

How similar studies have performed: Direct head-to-head comparisons of horizontal versus vertical cuff closure are limited, so this specific comparison is relatively novel though related work has examined other techniques to preserve vaginal length.

Eligibility criteria

Inclusion Criteria:

* Cases with vaginal hysterectomy and lateral suspension surgery due to stage 3-4 uterine prolapse Agree to participate in the study and sign the informed consent form

Exclusion Criteria:

* Cases that have previously undergone a different suspension surgery due to descent uteri (vaginal hysterectomy and sacrospinous ligament fixation surgery, vaginal hysterectomy and sacrocolopexy surgery, vaginal hysterectomy and high sacouterin plication surgery) Cases that have undergone vaginal hysterectomy due to malignancy Cases that have undergone radiotherapy due to malignancy (brachytherapy) Patients who are not suitable for surgical intervention due to severe vaginal atrophy.

Patients who will not be able to comply with the follow-up process. Not accepting to participate in the study or not signing the informed consent form

Where this trial is running

Istanbul

• Gaziosmanpaşa Training and Research Hospital — Istanbul, Turkey (Türkiye) (RECRUITING)

Study contacts

• Principal investigator: yagmur acıyiyen, md — Gaziosmanpasa Training and Research Hospital
• Study coordinator: serkan kumbasar, md

Conditions: Prolapse, Vaginal, Vaginal Vault Prolapse, Vault suspension, vaginal length