Utilization of Uterine Manipulator in Abdominal Hysterectomy
Condition: Sexual Function Disturbances
Study type: Interventional

Summary: 
      The investigators aimed to investigate whether the uterine manipulator which is usually
      utilized in laparoscopic hysterectomy would also be of benefit in preventing postoperative
      vaginal length and sexual function by facilitating the accurate localization fo the colpotomy
      site. Patients scheduled for abdominal hysterectomy for benign causes will be randomized into
      two arms: Group 1 Uterine manipulator arm in which participants received a uterine
      manipulator during the procedure for aiding to locate the accurate colpotomy site and Group 2
      consisting of control patients who will not receive uterine manipulator but undergo a
      standard abdominal hysterectomy. Postoperative vaginal length, postoperative female sexual
      function index (FSFI) will be compared with the preoperative measurements in the two groups.
      A 5 points Surgeon satisfaction scale will also be applied to the surgeons and residents
      performing the surgery to address their satisfaction in locating the colpotomy site.
    

Detailed description: 
      The uterine manipulator is a device that facilitates to locate the colpotomy site and
      visualization of surgical are during laparoscopic hysterectomy. The investigators consider
      that adoption of the uterine manipulator will also facilitate to locate the colpotomy site in
      abdominal hysterectomy. Therefore the investigators are planning to enroll patients
      undergoing an abdominal hysterectomy in this study. Patients will be allocated into one of
      the study groups: Group 1 Uterine manipulator arm in which participants received a uterine
      manipulator during the procedure for aiding to locate the accurate colpotomy site and Group 2
      consisting of control patients who will not receive uterine manipulator but undergo a
      standard abdominal hysterectomy. All abdominal hysterectomies will be carried out by the same
      surgeon under general anesthesia. One week before the surgery vaginal length will be measured
      and the female sexual function index (FSFI) will be obtained from all patients. Following the
      surgery vaginal length will again be measured at 3 months and the female sexual function
      index (FSFI) will be obtained from participants by a research staff who is also a
      gynecologist. Prevalence of postoperative dyspareunia will be asked to the patients at
      postoperative 3 months. Just after the surgery, a 5 points surgeons' satisfaction scale will
      also be completed by the surgeons and residents performing the surgery to address their
      satisfaction in locating the colpotomy site either with the uterine manipulator as in group 1
      or by manually guiding as in group 2.
    

Intervention name(s): The uterine manipulator which is primarily used in laparoscopic hysterectomy to accurately locate the colpotomy site. We adopted this device in abdominal hysterectomy.
Intervention type(s): Device
Intervention description(s): The uterine manipulator is primarily used in laparoscopic hysterectomy to accurately locate the colpotomy site. We hypothesized that adoption of a uterine manipulator would help the surgeon to better identify the colpotomy site by moving the uterus cranially and thus providing better visualization of the colpotomy site.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: abdominal hysterectomy; uterine manipulator; vaginal length; sexual function; surgeons' satisfaction