• Drains;
  • febrile morbidity;
  • vaginal hysterectomy;
  • vault haematoma

Please cite this paper as: Dua A, Galimberti A, Subramaniam M, Popli G, Radley S. The effects of vault drainage on postoperative morbidity after vaginal hysterectomy for benign gynaecological disease: a randomised controlled trial. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03170.x.

Objective  To evaluate the efficacy of vault drainage in reducing the immediate postoperative morbidity associated with vaginal hysterectomy carried out for benign gynaecological conditions.

Design  Randomised controlled trial.

Setting  A tertiary referral gynaecology centre in UK.

Population  A total of 272 women who underwent vaginal hysterectomy for benign conditions between March 2005 and June 2010.

Methods  The 272 women were randomised to have a drain inserted or not inserted, ‘drain’ or ‘no drain’, respectively, before vault closure during vaginal hysterectomy, using a sealed envelope technique. The surgical procedures were performed using the surgeons’ standard technique and postoperative care was delivered according to the unit’s protocol.

Main outcome measures  The primary outcome measure was reduction in postoperative febrile morbidity. Secondary outcome measures were hospital readmission rate, blood transfusion, change in postoperative haemoglobin and length of stay.

Results  In all, 135 women were randomised to have a drain and 137 to ‘no drain’. There were no differences in the incidence of febrile morbidity, length of stay, change in haemoglobin or need for postoperative blood transfusion between the two groups.

Conclusions  The routine use of vault drain at vaginal hysterectomy for benign disorders has no significant effect on postoperative morbidity. The use of vault drain in this context is not recommended.