“Hysterectomy by Vaginal Route,” not a Pressure

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

1. Sithara Dharmarajan
Publishing Year
Author Affiliations
    1. Department of Obstetrics and Gynaecology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
  • Article keywords
    Benign gynecological disorders, Hysterectomy, Nondescent vaginal hysterectomy, Non prolapsed uterus


    Vaginal route of hysterectomy is a safe procedure with less morbidity and hospital stay. So there is a need to expand the indication for vaginal hysterectomy beyond uterovaginal prolapse. Aim: To determine the feasibility and outcome of nondescent vaginal hysterectomy (NDVH) and to assess pre and postoperative complications, duration of surgery, and length of hospital stay. Materials and methods: A prospective observational study was conducted between 2012 and 2014 at a tertiary care center. Two hundred fifty-six patients satisfying the selection criteria of hysterectomy for benign gynecological conditions, uterus size <16 weeks and excluding stage IV endometriosis, genital tract malignancy, and uterine prolapse were included. Nondescent vaginal hysterectomy was performed by the standard technique and the following parameters were recorded: age, parity, indication for surgery, duration of surgery, intra operative and postoperative complications, and hospital stay. The data were analyzed using SPSS version 16.0 by frequency and percentage analysis using Chi-squared test. Results: All 256 patients were analyzed. The mean age was 44.4 ± 6.1 years, fibroid uterus was the commonest indication, 89.4% had a uterine size ≤12 weeks, and 59% had uterine volume <200 cm3. The mean duration of surgery was 83.5 ± 11.0 minutes; salpingo-oophorectomy was performed in 25.8% of the patients. Intraoperatively 1.2% had bladder injury and 0.4% required conversion to laparotomy for pelvic hematoma. The mean duration of hospital stay was 4.9 ± 2.2 days and the mean pain score in NRS pain scale was 3.0 ± 0.3. Intraoperative blood transfusion was required in 1.9% of the patients only. Conclusion: Nondescent vaginal hysterectomy is a safe and feasible procedure for benign gynecological disorders. Clinical significance: Nondescent vaginal hysterectomy is a boon in this techno-savvy era by reducing the morbidity and promising early return to work.

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