V-NOTES Versus Laparoscopy for Sterilization and Sexual Function (VNOTES-LS-FSFI)

June 5, 2026 updated by: Onur Ada, Tepecik Training and Research Hospital

Randomised Prospective Comparison of Sexual Function and Postoperative Recovery Following V-NOTES Versus Laparoscopic Bilateral Tubal Ligation and Salpingectomy

The goal of this randomized clinical trial is to compare two minimally invasive surgical approaches, transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) and conventional laparoscopy, in women undergoing bilateral tubal ligation or bilateral salpingectomy for sterilization.

The main questions it aims to answer are:

  • Does V-NOTES have a different effect on postoperative sexual function compared with conventional laparoscopy?
  • Does V-NOTES improve postoperative recovery, including pain, discharge time, and return to normal activity?
  • What surgical or medical problems occur with each surgical approach?
  • Researchers will compare V-NOTES with conventional laparoscopy to see whether one approach provides better postoperative sexual function and recovery outcomes after sterilization surgery.

Participants will:

  • Undergo bilateral tubal ligation or bilateral salpingectomy using either V-NOTES or conventional laparoscopy.
  • Complete sexual function questionnaires before surgery, at 6 weeks after surgery, and at 6 months after surgery.
  • Be evaluated for postoperative pain, discharge time, return to normal activity, need for additional pain medication, complications, and perioperative laboratory changes.
  • Attend scheduled postoperative follow-up visits at 6 weeks and 6 months after surgery.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

118

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Women aged 30 to 45 years
  • Sexually active women
  • Women who have completed childbearing and request permanent surgical sterilization
  • Scheduled to undergo bilateral tubal ligation or bilateral salpingectomy for contraceptive purposes
  • Able and willing to attend scheduled postoperative follow-up visits at 6 weeks and 6 months
  • Able to provide written informed consent

Exclusion Criteria:

  • Stage 2 or higher pelvic organ prolapse
  • Active vaginal infection
  • History of rectal surgery
  • Suspected rectovaginal endometriosis
  • Suspected malignancy
  • Pregnancy
  • Menopause
  • Unable or unwilling to attend scheduled postoperative follow-up visits

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: V-NOTES
Participants assigned to this arm will undergo sterilization surgery, either bilateral tubal ligation or bilateral salpingectomy, using the V-NOTES approach.
Procedure: V-NOTES Bilateral Tubal Ligation or Salpingectomy
Transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) will be used to perform bilateral tubal ligation or bilateral salpingectomy for sterilization. In this approach, the peritoneal cavity will be accessed through a posterior vaginal fornix incision. A single-port transvaginal access platform will be inserted, and the sterilization procedure will be completed under endoscopic visualization. At the end of the procedure, the posterior vaginal fornix incision will be closed with absorbable suture.
Active Comparator: Laparoscopy
Participants in this arm will undergo bilateral tubal ligation or bilateral salpingectomy for sterilization using conventional laparoscopy.
Procedure: Laparoscopic Bilateral Tubal Ligation or Salpingectomy
Laparoscopy will be used to perform bilateral tubal ligation or bilateral salpingectomy for sterilization. In this approach, the procedure will be performed through standard abdominal trocar access, including an umbilical trocar for laparoscope insertion and two additional lower abdominal trocars for surgical instruments. The sterilization procedure will be completed under laparoscopic visualization, and the abdominal skin incisions will be closed at the end of the procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in postoperative sexual function as assessed by the Female Sexual Function Index total score
Time Frame: Baseline, postoperative 6th week, and postoperative 6th month
The Female Sexual Function Index is a 19-item self-reported questionnaire that evaluates female sexual function across six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The total score ranges from 2.0 to 36.0, with higher scores indicating better sexual function. The outcome will be reported as the change in total Female Sexual Function Index score from baseline to 6 weeks and 6 months after surgery. A positive change indicates improvement in sexual function, whereas a negative change indicates worsening.
Baseline, postoperative 6th week, and postoperative 6th month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Body mass index (BMI)
Time Frame: Baseline
Baseline
History of previous obstetric and non-obstetric surgery
Time Frame: Baseline/preoperative assessment
Previous surgical history will be assessed preoperatively using a structured case report form and review of the participant's medical records. Obstetric surgery includes previous cesarean section or surgery for pregnancy-related indications. Non-obstetric surgery includes previous gynecologic, abdominal, pelvic, or other surgical procedures unrelated to pregnancy. The number and percentage of participants with previous surgery will be compared between the V-NOTES and laparoscopy groups.
Baseline/preoperative assessment
Participants With Pre-existing Comorbidities Assessed by Medical History and Medical Record Review
Time Frame: Baseline
Pre-existing comorbidities will be assessed at baseline using participant medical history and medical record review. Comorbidities will include chronic systemic diseases such as hypertension, diabetes mellitus, cardiovascular disease, thyroid disease, pulmonary disease, and other relevant chronic conditions. The outcome will be reported as the number and percentage of participants with at least one pre-existing comorbidity in each study group.
Baseline
Duration of the surgical prosedure
Time Frame: Intraoperative
Defined as the time in minutes from the initial incision to completion of skin closure
Intraoperative
Estimated intraoperative blood loss volume measured in milliliters
Time Frame: Intraoperative
Estimated intraoperative blood loss will be assessed during surgery and recorded in milliliters (mL). Blood loss will be estimated based on the volume of blood collected in the suction canister.
Intraoperative
Postoperative inflammatory marker - Neutrophil-to-lymphocyte ratio
Time Frame: Preoperative and postoperative first day
Neutrophil-to-lymphocyte ratio
Preoperative and postoperative first day
Postoperative inflammatory marker
Time Frame: Preoperative and postoperative first day
platelet-to-lymphocyte ratio
Preoperative and postoperative first day
Time to return to normal activity (day)
Time Frame: Postoperative (up to 6 months)
Postoperative (up to 6 months)
Length of hospital stay (hour)
Time Frame: Postoperative (up to 1 week)
Postoperative (up to 1 week)
Need for additional analgesic doses
Time Frame: Postoperative (up to 3 days)
Postoperative (up to 3 days)
Complications
Time Frame: Intraoperative, postoperative (up to 6 months)
Intraoperative (bleeding, organ injury) Postoperative (infection, wound dehiscence, rectovaginal fistula, readmission within the first 6 weeks, dyspareunia)
Intraoperative, postoperative (up to 6 months)
Visual analog scale (VAS)
Time Frame: Postoperative 6th and 24th hour
Postoperative pain will be assessed using the Visual Analog Scale, an 11-point pain intensity scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse postoperative pain. The mean Visual Analog Scale score will be compared between the V-NOTES and conventional laparoscopy groups.
Postoperative 6th and 24th hour

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tepecik Training and Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 6, 2025

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

June 1, 2026

First Submitted That Met QC Criteria

June 5, 2026

First Posted (Actual)

June 9, 2026

Study Record Updates

Last Update Posted (Actual)

June 9, 2026

Last Update Submitted That Met QC Criteria

June 5, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • VNOTES-LAP-STER-FSFI-2025
  • 2025/07-17 (Other Identifier: The Ethics Committee of Izmir Tepecik Training and Research Hospital)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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