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Cruikshank SH, Kovac SR. Randomized comparison of three surgical methods used at the time of vaginal hysterectomy to prevent posterior enterocele. Am J Obstet Gynecol. 1999 Apr;180:859-65.
Question
In women who are having vaginal hyster- ectomy, which vaginal cuff suspen- sion technique provides the best sur-gical prophylaxis against enterocele formation?
Design
Randomised (concealed), unblinded, controlled trial with 3-year follow-up.
Setting
Wright State University, Dayton, Ohio, United States.
Patients
100 women who were 24 to 77 years of age (mean age 40 y, mean parity 2 deliveries) and were having total vaginal hysterectomy. The exclusion criterion was a primary diagnosis of symptomatic pelvic organ prolapse involving the posterior vaginal segment. Follow-up at 3 years was 98%.
Intervention
Women were allocated to 1 of 3 surgical methods for closing the posterior supe- rior compartment of the vagina: a Moschcowitz-type purse-string closure, in which uterosacral and cardinal …