Preservation of Vaginal Length by Vertical vs Horizontal Vault Closure Technique after Vaginal Hystrectomy

Objective: To compare vaginal length preservation between vertical and horizontal vault closure technique after vaginal hystrectomy. Methods: Randomized prospective Study was conducted at two private hospitals in Kashmir valley. 46 women who attended gynecology clinic between Jan 2016 to Jan 2021 with POPQ grade 1 prolapse were randomized into two groups according to vaginal vault closure technique (horizontal 23 vs vertical 23). Results: Vaginal length measured pre-operatively between horizontal and vertical group was similar with mean ±SD (7.6±0.82) and 7.79±0.80). Immediate postoperative vaginal length was significantly short in horizontal group as compared to vertical closure group with mean±SD (6.4±0.88) and 7.31±0.72). Mean difference in vaginal length between two groups before and after surgery was 1.2(0.12) centimeters (horizontal) and 0.4(0.11) centimeters vertical group. P<.001 Conclusion: vertical vaginal vault closure preserves vaginal length as compared to horizontal vault closure. Keywords: vault closure, vaginal hystrectomy, vaginal length, vertical, horizontal.