1. Introduction
Vaginal hysterectomy is a common surgical procedure that approximately one in ten women will have undergone by age 80 years (1). Moreover, given the ageing population, rates of uterovaginal prolapse and surgical intervention could increase by almost 50% by the year 2050 (2). As with any procedure, vaginal hysterectomy can produce complication, and traditionally, vaginal packing has been used to reduce the risk of haemorrhagic (e.g., vaginal bleeding and/or hematoma) and infectious (e.g., vaginal cuff abscess formation) complications. However, vaginal packing may impair spontaneous bladder emptying and usually necessitates the placement of a permanent bladder catheter (most often with a Foley catheter) at the time of packing. This, in turn, increases the risk of urinary infection, patient bother, and delayed discharge, and it negatively affects costs (3,4). Therefore, care is required when evaluating the need for packing. Though the duration of packing has apparently shortened in the recent years, consensus has not been reached on the suitability and optimal use of this intervention due to insufficient evidence.
The aim of this systematic review was to compare the complications and outcomes between interventions that use and do not use vaginal packing after vaginal hysterectomy with or without colporrhaphy.