Vaginal cuff dehiscence (VCD) is a rare but potentially serious complication of hysterectomy. VCD refers to full-thickness separation of the vaginal epithelium edges [1]. Potential sequelae include peritonitis, sepsis, or evisceration of abdominal contents [2]. VCD's rarity limits data availability on incidence, risk factors, and measures to reduce occurrence. Studies estimate that the incidence of VCD ranges from 0.14% to 4.1% [1,3,4]. Dehiscence occurs more frequently following total laparoscopic (robotic and conventional laparoscopic) hysterectomy (TLH) than total abdominal hysterectomy (TAH) or total vaginal hysterectomy (TVH) [3,5,6]. Research focused on VCD thus becomes even more relevant as minimally invasive gynecologic surgery (MIGS) outpaces traditional approaches [7-9].

Most of the literature regarding VCD in MIGS hysterectomy focuses on surgical means of improving dehiscence rates, specifically suture type and closure technique [3,9-13]. The absence of reporting asymptomatic VCD noted on routine post-operative examination in the literature calls into question the widespread practice of vaginal cuff examination at all post-operative visits. Additionally, reported time between hysterectomy and VCD ranges from 6.1 weeks to 1.6 years, beyond the time when most post-operative visits occur, raising further questions around the ability to detect findings on routine exams in asymptomatic patients that would result in interventions to prevent VCD [3,10,14]. In this study, our objective was to examine the utility of routine post-operative vaginal examination in asymptomatic patients following TLH by comparing the incidence of VCD in patients whose follow-up included a pelvic exam with those whose did not.