Evidence map›Paper›PMID 30694343›Full record

SynthesisInternational urogynecology journal2019

Impact of vertical versus horizontal vaginal cuff closure on vaginal length following hysterectomy: a meta-analysis of randomized trials.

Vasilios Pergialiotis, Georgios Daskalakis, Nikolaos Thomakos, Dimitrios Haidopoulos, Dimitrios Loutradis, Alexandros Rodolakis

Abstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in International urogynecology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Vasilios PergialiotisLaboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, 6, Danaidon str, 15232, Halandri, Greece. pergialiotis@yahoo.com.ORCID 0000-0003-3409-0844
Georgios Daskalakis1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Nikolaos Thomakos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Dimitrios Haidopoulos1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Dimitrios Loutradis1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Alexandros Rodolakis1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisPosthysterectomy vaginal length has been previously associated with postoperative sexual dysfunction, but evidence for this in the literature is controversial. The purpose of this meta-analysis was to investigate whether vertical or horizontal closure of the vaginal cuff has a direct effect on posthysterectomy vaginal length and on postoperative sexual dysfunction.

methodsThe study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched Medline, Scopus, Clinicaltrials.gov , EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar databases.

resultsOverall, five randomized trials were included in this meta-analysis with 223 patients. The results suggest that horizontal closure of the vaginal cuff results in a shorter vaginal length compared with vertical closure [mean difference (MD) -0.77 cm, 95% confidence interval (CI) -1.12 to -0.43]. Mean vaginal length significantly decreased when the horizontal method was used (MD -0.61 cm, 95% CI -0.97 to -0.24). The subgroup analysis revealed that vertical closure was associated with longer vaginal length only in cases treated with vaginal hysterectomy. Trial sequential analysis revealed that our meta-analysis had adequate power to support these results. Postoperative sexual function was evaluated in only one study; no differences were observed.

conclusionsFindings of our meta-analysis suggest that horizontal closure of the vaginal vault results in shorter vaginal length in vaginal hysterectomies; thus, we suggest that this technique be avoided. Data concerning quality of life of patients and specifically sexual dysfunction remain extremely limited and should be studied in future trials.

Indexed as

FemaleHumansHysterectomyOrgan SizeRandomized Controlled Trials as TopicVaginaDyspareuniaHorizontalHysterectomyMeta-analysisVaginal cuffVertical

Identifiers

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.