Effect of Posterior Colpotomy First Technique on the Vaginal Length During Total Abdominal Hysterectomy

NCT07308197 | Completed DMC

• 1 other identifier: 367
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

the same surgeon performed all of the procedures using the same method. A lower midline or Pfannestiel incision is the first step in the complete abdominal hysterectomy procedure. They clamp, cut, and ligate the top pedicles. The cardinal and uterosacral ligaments were dissected, the wide ligament's leaves were cut, the bladder was carefully lowered, and the uterine vessels were skeletonized, cut, and tied. Group A (traditional technique): the surgeon makes a circumferential incision after initially entering the front vaginal wall. The surgeon performs a circumferential colpotomy at the topmost section of the vagina using the Group B (posterior colpotomy first) approach, entering the vagina via the posterior wall at the uppermost part of the uterosacral ligaments, followed by the left lateral fornix. Reconstruction of the pelvic floor to ensure hemostasis and good pelvic support. The operative time was assessed by calculating the time between vaginal cuff opening and suturing after uterine artery ligation, As point D on the POP-Q system is omitted after hysterectomy, point C level was reassessed 2 weeks postoperative.

Conditions

Hysterectomy, Benign Uterine Diseases

Keywords

hystrectomy; posterior colopotomy; Vaginal length

Outcome Measures

Primary Outcomes (1)

• Total vaginal length

  calculated according to the formula TVS=Preoperative VL-Postoperative VL

  after 3 months

Study Arms (2)

Group A (Classic technique):

ACTIVE COMPARATOR

the surgeon makes a circumferential incision after initially entering the front vaginal wall. The surgeon performs a circumferential colpotomy at the topmost section of the vagina

Procedure: Abdominal hysterectomy

Group B (posterior colpotomy first) approach

ACTIVE COMPARATOR

entering the vagina via the posterior wall at the uppermost part of the uterosacral ligaments, followed by the left lateral fornix

Procedure: Abdominal hysterectomy

Interventions

Abdominal hysterectomy PROCEDURE

A lower midline or Pfannestiel incision is the first step in the complete abdominal hysterectomy procedure. They clamp, cut, and ligate the top pedicles. The cardinal and uterosacral ligaments were dissected, the wide ligament's leaves were cut, the bladder was carefully lowered, and the uterine vessels were skeletonized, cut, and tied

Group A (Classic technique):; Group B (posterior colpotomy first) approach

Eligibility Criteria

• Age: 40 Years - 65 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Ages 40 - 65 years
• sexually active
• BMI of 25-40 kg/m2
• had a fresh abdomen
• had a benign reason for a hysterectomy (multiple fibroid uterus, adenomyosis, or endometrial hyperplasia).

You may not qualify if:

• Patients who had vaginal and uterine prolapse,
• subtotal hysterectomy,
• caesarean hysterectomy in patients with major obstetric hemorrhage (placenta previa, accreta-increta-percreta, uncontrolled postpartum hemorrhage)
• malignant indications of total abdominal hysterectomy (uterine and cervical carcinoma)

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Cairo university

Cairo, Cairo Governorate, 12111, Egypt

Location

Study Officials

• Ahmed Maged

  Cairo University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: A lower midline or Pfannestiel incision is the first step in the complete abdominal hysterectomy procedure. They clamp, cut, and ligate the top pedicles. The cardinal and uterosacral ligaments were dissected, the wide ligament's leaves were cut, the bladder was carefully lowered, and the uterine vessels were skeletonized, cut, and tied.

Study Record Dates

• First Submitted: December 15, 2025
• First Posted: December 29, 2025
• Study Start: March 30, 2023
• Primary Completion: March 25, 2024
• Study Completion: September 16, 2024
• Last Updated: December 29, 2025

Record last verified: 2025-12

Locations

EG (1)