The American Association of Gynecologic Laparoscopists (AAGL) recommends that “most hysterectomies for benign disease should be performed either vaginally or laparoscopically.” PFDs (pelvic floor diseases) includes vaginal bulging, urinary or fecal incontinence, pelvic organ prolapse (POP), pelvic pain, pelvic pressure or a sense of heaviness, difficulties emptying the bladder, and other sensory and emptying abnormalities of the gastrointestinal tract. These complaints can cause sexual inactivity. Given the sensitive nature of prolapse with its effect on physical appearance of female genitals, particularly when the condition is advanced, it seems likely that such prolapse would render at least some women self-conscious. Major concern after POP surgery includes not only successful anatomical correction of any protrusion but also the impact of surgery on the quality of life including sexual life.

Only a few prospective comparative studies on sexual function before and after POP surgery have been conducted, and only a few studies have attempted to define the optimal method of vaginal cuff closure after vaginal hysterectomy (VH). Those that have, have done so only in terms of the effects of the closure type on vaginal length; they did not assess the effects of various techniques on sexual functioning. To address this area, we prospectively evaluated sexual function in women before and after VH with McCall Culdoplasty and compared the effects of horizontal and vertical vaginal cuff closure on sexuality.