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.