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    How should we enter peritoneum in vaginal hysterectomy?
    (Bayrakol Medical Publisher, 2022) Demir, Emine Tueren; Energin, Hasan
    Aim: Anterior and posterior entrances to the peritoneal cavity are essential steps in vaginal hysterectomy. The objective of this study was to compare surgical techniques and results in women who had primarily anterior colpotomy or primarily posterior colpotomy to enter the peritoneum in vaginal hysterectomy. Material and Methods: We analyzed the data of 90 women who underwent vaginal hysterectomy by the same surgical team in a university hospital between 2017 and 2021. The patients have divided into two groups: primarily anterior colpotomy or primarily posterior colpotomy. Operation time, amount of bleeding, and complication rates were compared between the two groups. Results: First anterior colpotomy was performed in 44 patients, and the first colpotomy posterior was performed in 46 patients. Patient characteristics were similar in both groups. The mean age of the patients was 63.6 +/- 8.6 years, and the mean number of pregnancies was 3.07 +/- 1.05. The mean preoperative and postoperative hemoglobin difference was 1.5 +/- 0.6 g/dl. The mean uterine length was 9.33 +/- 2.07 cm, and the mean uterine weight was calculated as 118.1 +/- 42.2 g. The operation time was significantly shorter in the first colpotomy posterior group (67.5 +/- 7.7 min vs. 78.1 +/- 12.6 min p<0.05). While no significant complications were observed in the first posterior colpotomy group, one bladder injury was observed in the first anterior colpotomy group. Discussion: In a vaginal hysterectomy, when posterior colpotomy is performed first, Entrance into the peritoneal cavity is safer and quicker. Thus, surgeons feel more comfortable and secure while performing a vaginal hysterectomy and return to abdominal procedures minimally.