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Section-02A Vaginal Hysterectomy with History of Caesarean Section(s)

BOOK TITLE: Advanced Vaginal Surgery

Author
1. Sheth Shirish S
2. Finkelstein Seth
ISBN
9789352700172
DOI
10.5005/jp/books/14124_3
Edition
1/e
Publishing Year
2018
Pages
24
Author Affiliations
1. Breach Candy Hospital, Sir Hurkisondas Nurrotamdas Hospital and Sheth Nursing Home, 2/2, Navjivan Society, Lamington Road, Mumbai, India, e-mail:silsal@bom2.vsnl.net.in, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, silsal@bom2.vsnl.net.in, Sir Hurkisondas Nurrotamdas and Saifee Hospitals, Mumbai, Maharashtra, India, Breach Candy Hospital and Sir Hurkisondas Nurrotamdas Hospital, Mumbai, Maharashtra, India, Breach Candy Hospital, Sir Hurkisondas Hospital and Saifee Hospital, Mumbai, Maharashtra, India, Mumbai, King Edward Memorial Hospital and Seth GS Medical College, Mumbai, Maharashtra, India (1964–1994); International Federation of Gynecology and Obstetrics (FIGO) from 2000–2003; Breach Candy and Saifee Hospitals, Mumbai, Maharashtra, India, Breach Candy, and Saifee Hospitals, Mumbai, Maharashtra, India; International Federation of Gynecology and Obstetrics (FIGO), 2000-2003
2. Lenox Hill Hospital, Manhattan, Kingsbrook Jewish Medical Center, Brooklyn, New York, USA
Chapter keywords
Vaginal hysterectomy, VH, caesarean section, stress urinary incontinence, SUI, salpingo-oophorectomy, BSO, vesicouterine peritoneum, VUP, uterine debulking, ovarian cystectomy

Abstract

This section focuses on vaginal hysterectomy with history of caesarean section(s). A mere history of (H/O) caesarean sections in the past is enough to inhibit many gynecologists from performing hysterectomy via the vaginal route. However, to have a history of rupture uterus per se is highly disturbing and inhibiting to even consider removal of such a uterus via the vaginal route. A rupture in the past added to a history of previous caesarean sections is even more daunting to consider vaginal hysterectomy (VH) because of the possibility of adhesions, difficulty in getting a plane of cleavage and a high risk of damaging the bladder and/or rectum and more. This section comprises of 13 sections that are described as VH with left ovarian cystectomy, VH plus stress urinary incontinence (SUI) repair, VH with uterine debulking, VH with left salpingo-oophorectomy for ovarian endometrial cyst in a morbidly obese patient, VH with bilateral salpingo-oophorectomy (BSO) for right ovarian endometriotic cyst, VH with altered approach to vesicouterine peritoneum (VUP), VH plus bilateral salpingectomy after one caesarean and no vaginal births, and VH with uterine debulking after six midline vertical laparotomies (five caesarean sections and one ectopic pregnancy) in a morbidly obese cigarette smoker.

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