Role of routine vault drainage at vaginal hysterectomy
Article first published online: 17 JUN 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 8, page 1016, July 2012
How to Cite
Dua, A. (2012), Role of routine vault drainage at vaginal hysterectomy. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 1016. doi: 10.1111/j.1471-0528.2012.03317.x
- Issue published online: 17 JUN 2012
- Article first published online: 17 JUN 2012
- Accepted 16 February 2012.
We appreciate the interest in our article and thank Drs Spencer, Fiadjoe and Abdel-Razzek for their comments.1 We respond to their concerns in the section below.
A large proportion of hysterectomies included in the study were performed for prolapse. However, not all hysterectomies for prolapse were performed in postmenopausal women. Also, in a number of women, there was more than one indication for hysterectomy of which only the primary indication was described in the article. We would like to point out that the proportion of women who were postmenopausal is not mentioned in the article and has been inferred from the indications; an inference that is incorrect. The relative ease of operation and possible reduced morbidity of vaginal hysterectomy in women with prolapse has already been acknowledged as a limitation in the Discussion.2
In response to their second comment; the primary outcome measure in the study was reduction in immediate postoperative febrile morbidity and the study was powered to evaluate this in the two groups. In addition, we looked at a small number of secondary outcome measures associated with significant morbidity including readmission to the hospital. The study was not adequately powered to look at the difference in prescription of antibiotics in the community following discharge and therefore, could not be assessed in the context of this study.
The article describes the first study to assess the efficacy of drains at vaginal hysterectomy. As there were no previous studies to refer to, it was difficult to predetermine the duration of a vaginal drain. In fact, leaving the removal time up to the operating surgeons ensured that all drains were removed once they stopped draining, thereby reducing any potential bias.
- 1Role of routine vault drainage at vaginal hysterectomy. BJOG 2012;119:1015–6., , .