Vaginal Cuff Dehiscence

Vaginal cuff dehiscence (VCD) is a rare but serious complication post total hysterectomy, characterized by the separation of the vaginal cuff incision. Patients typically present with abdominopelvic pain, bleeding, or vaginal pressure, often triggered by the first coitus postoperatively. Risk factors include comorbidities affecting wound healing, increased intra-abdominal pressure, and the mode of hysterectomy. Minimally invasive approaches show lower VCD rates. Specific surgical techniques, such as a two-layer vaginal cuff closure with angle sutures, may significantly reduce VCD incidence. Management strategies emphasize on prompt diagnosis, clinical stability assessment, and appropriate surgical repair with prioritizing normal anatomy restoration. Prevention of VCD includes optimizing preoperative conditions, treating co-morbidities, and employing meticulous intraoperative techniques. A postoperative period of pelvic rest, attentive constipation management, and antibiotic prophylaxis contribute to minimizing the risk and morbidity associated with VCD and thus enhance post-hysterectomy patient care.