Mehmet Emre PEKER, Ufuk ATLIHAN, Can ATA, Duygu UÇAR KARTAL, Haydar KAYA
Cyprus Journal of Medical Sciences - 2026;11(5):353-358
BACKGROUND/AIMS: To evaluate whether the technique used for vaginal cuff closure after total laparoscopic hysterectomy (TLH) influences perioperative outcomes and early postoperative sexual function. MATERIALS AND METHODS: Clinical records from women undergoing TLH for benign gynecological indications at Buca Seyfi Demirsoy Training and Research Hospital during the period from January 2021 to December 2024 were retrospectively evaluated. Patients were assigned to either a transvaginal suturing group (n=71) or a laparoscopic intracorporeal suturing group (n=55), according to the route of vaginal cuff closure. Demographic characteristics, operative variables, perioperative complications, vaginal length measurements, and female sexual function index (FSFI) scores were analyzed. Sexual function was assessed before surgery and again three months postoperatively. RESULTS: No statistically significant differences were observed between the groups regarding baseline characteristics. Women in the laparoscopic closure group demonstrated significantly greater postoperative vaginal length compared with those who underwent transvaginal closure. The duration of surgery and the length of hospitalization were similar. Although both techniques were associated with postoperative improvement in FSFI scores, the degree of improvement was significantly higher among patients who received laparoscopic cuff closure. CONCLUSION: Intracorporeal laparoscopic closure of the vaginal cuff following TLH is associated with improved preservation of vaginal length and greater enhancement of early postoperative sexual function compared with the transvaginal approach.
