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Issues around vaginal vault closure

Vaginal cuff dehiscence (VCD), vault prolapse, vaginal cuff granulation and infected vault haematoma are adverse events following hysterectomy. There are several approaches to closing the vaginal cuff, each using different techniques and sutures. Dehiscence of the vaginal cuff is more common with laparoscopic hysterectomy. Techniques that minimise excessive use of diathermy may reduce the risk of vault dehiscence. The incidence of post‐hysterectomy vault prolapse is estimated to be between 1.8% and 11.6%. McCall culdoplasty seems to be effective in supporting the vaginal vault. Different techniques are used to minimise the development of vault haematoma and granulation tissue.