The effect of hysterectomy on colonization of the vaginal vestibule with Escherichia coli

Using an experimental model in the rabbit, it was demonstrated for the first time that hysterectomy significantly prolongs introital carriage of Escherichia coli. Normal and oophorectomized rabbits rapidly clear E. coli from the mucosa of the vaginal vestibule. The altered vaginal biology induced by hysterectomy lends credence to the clinical observation that some hysterectomized women are unusually susceptible to urinary infections. These data may be the first to indicate that the 700,000 hysterectomies performed each year in the United States may adversely affect vaginal biology. Reexposure of the vaginal mucosa of hysterectomized rabbits to E. coli produced rapid clearing of the organism characteristic of a secondary immunologic response. The presence of secretory antibodies in cervical and vaginal secretions and the occurrence of systemic antibodies after vaginal inoculation supports an immunologic role in determining vaginal carriage of Gram negative organisms.