Objective: The goal of this research was to determine the incidence of vaginal cuff dehiscence after all types of total hysterectomies and to identify potential risk factors for dehiscence. Design: A retrospective chart review was performed to identify the incidence of vaginal cuff dehiscence after hysterectomy. This review was followed by a case-control study to identify risk factors for dehiscence (Canadian Task Force classification II-2). Materials and Methods: A retrospective chart review was performed on all women, at two institutions, who experienced vaginal cuff dehiscence after total hysterectomy over a 10-year period. All patients who experienced cuff dehiscence after any type of hysterectomy were included to determine the incidence of vaginal cuff dehiscence. A case-control study was then performed to identify risk factors for dehiscence. Results: Between 2000 and 2010 there were 4235 total hysterectomies performed and 8 dehiscences giving an overall incidence of vaginal cuff dehiscence of 0.19%. There were the following dehiscences: 1 after total laparoscopic hysterectomy (TLH; incidence: 0.59%, 95% confidence interval [CI]: −0.5% to 1.7%); 1 after laparoscopically assisted vaginal hysterectomy (incidence: 0.19%, 95% CI: −0.19 to 0.56%); 1 after robotic-assisted TLH (incidence: 0.52%, 95% CI: −0.50 to 1.6%); 5 after total abdominal hysterectomy (incidence; 0.19%; 95% CI: −0.02–0.36%); and 0 after vaginal hysterectomy. There was no significant increase in risk detected in this study when examining mode of hysterectomy as a risk factor for dehiscence. Conclusions: The reported incidence of vaginal cuff dehiscence after laparoscopic and robotic hysterectomy may be lower than had been reported previously. (J GYNECOL SURG 30:276)
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