A simple procedure to prevent chronic vaginal colpotomy wound bleeding after laparoscopically assisted vaginal hysterectomy

Objective: To determine whether injecting the colpotomy wound with diluted vasopressin decreases vaginal bleeding after laparoscopically assisted vaginal hysterectomy (LAVH). Methods: In this prospective controlled study 100 patients who underwent LAVH from July 1, 2005 to June 30, 2007, were randomized to receive an injection of vasopressin (n = 50) or normal saline (n = 50) solution in the colpotomy wound. Results: In the vasopressin group, bleeding from the colpotomy wound occurred for more than 7 days in 9 patients (18%), and none was bleeding after 1 month; in the control group, the corresponding values were 29 (58%) and 2 (4%). Compared with the study group, the control group had a significantly higher rate of chronic bleeding from the colpotomy wound for more than 7 days and for more than 14 days after LAVH (P <0.001 for both). Conclusion: Infiltrating the colpotomy wound with diluted vasopressin was found to prevent chronic vaginal bleeding, which frequently occurs following LAVH.