Apical Support After Benign Laparoscopic Hysterectomy: A Randomized Controlled Trial Comparing Vaginal Cuff Closure Techniques.

Kathryn A Edmonds, Christine M Vaccaro, Candice E Jones-Cox, Katherine L Dengler, Thuan H Le, Scott P Endicott

Abstract readRandomized Controlled TrialComparative Study

In one paragraph

Trial report in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

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1 · What the graph read from it

What it found

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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.

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kathryn A EdmondsMinimally Invasive Gynecologic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA. ka.edmonds421@gmail.com.ORCID http://orcid.org/0000-0002-5795-7757

Christine M VaccaroFemale Pelvic Medicine and Reconstructive Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.

Candice E Jones-CoxMinimally Invasive Gynecologic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA.

Katherine L DenglerFemale Pelvic Medicine and Reconstructive Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.

Thuan H LeMinimally Invasive Gynecologic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA.

Scott P EndicottMinimally Invasive Gynecologic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction and hypothesisThe route of vaginal cuff closure after laparoscopic hysterectomy has not been standardized. This study was designed to compare pelvic floor support after vaginal or laparoscopic cuff closure. The authors hypothesized that laparoscopic closure would be superior.

methodsThis randomized controlled trial included women undergoing a benign total laparoscopic hysterectomy. Exclusion criteria included concurrent prolapse procedure, malignancy, and a pelvic organ prolapse quantitation system (POPQ) point C greater than -4. Preoperative POPQ exams were performed by blinded Urogynecologists. Patients were randomized to vaginal or laparoscopic cuff closure on the day of surgery. POPQ exams were repeated by blinded Urogynecologists at 6-8 weeks and 1 year postoperatively. Using a corrected alpha of 0.05 and power 0.8 to detect a 1.75 cm difference, the required sample size was 62 with 31 patients per group. Categorical variables were compared using the chi-squared or Fisher exact tests. Continuous variables were compared using a two-tailed t-test.

resultsFifty-seven patients were enrolled. Forty-four patients completed 6-8 week follow-up, and 33 patients were evaluated at 1 year. The calculated sample size was not obtained as patient enrollment and retention were impacted by the COVID-19 pandemic. The mean difference of point C between laparoscopic and vaginal closure was 0.98 cm and 1.24 cm, respectively, at 6-8 weeks (p = .55), and 1.22 cm and 1.63 cm, respectively, at 1 year (p = .48). Mean differences for all other POPQ exam points and complication rates were nonsignificant.

conclusionsFor up to 1 year postop, there is no significant difference in apical support when comparing laparoscopic to vaginal cuff closure.

Indexed as

HysterectomyLaparoscopyPelvic FloorVaginaAdultFemaleHumansMiddle AgedPelvic Organ ProlapseTreatment OutcomeMinimally invasive hysterectomyPOP-QProlapseVaginal cuff closureVaginal support

Identifiers

PMID41865172

DOI10.1007/s00192-026-06609-4

What OpenQuestion holds

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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.