Effects of Using Uterine Manipulator on Vaginal Length After Abdominal Hysterectomy: A Prospective Randomized Study

Objective: This study aims to research the effects of the uterine manipulator on operation time, complications, and postoperative vaginal length in abdominal hysterectomies.Materials and Methods: Eighty-five women underwent abdominal hysterectomy and were randomized into two groups: a study group using a uterine manipulator (n=35) and a control group (n=50). The study recorded demographic characteristics, indications for hysterectomy, intraoperative blood loss, changes in postoperative hemoglobin, and postoperative vaginal lengths. Vaginal length was measured preoperatively and on the first postoperative day. The primary outcome, the effect of uterine manipulator usage on vaginal length, was analyzed using a Student’s t-test.. Pearson’s correlation test was used to evaluate the correlation between intraoperative blood loss and postoperative vaginal length. P values < 0,05 were considered significant.Results: No significant differences were found between the groups regarding demographic data and hysterectomy indications. Postoperative vaginal length change was statistically less in the study group than in the control group (p<0,001). We also observed that less intraoperative blood loss was associated with less shortening of postoperative vaginal length (p<0,001). Intraoperative blood loss was significantly less in the study group compared to the control group (study group: 347±169 ml; control group: 439±150 ml; p=0,010). There was no significant difference in operation time between the groups (p=0.178), and no correlation was found between postoperative vaginal length and BMI.Conclusion: The result of this study indicated that using a uterine manipulator in abdominal hysterectomy might be preferable due to better postoperative vaginal length and less intraoperative blood loss.