Hysterectomy by Vaginal Route: Not a Pressure

JOURNAL TITLE: Journal of SAFOMS

Author
1. Sithara Dharmalingam
ISSN
2319-846X
DOI
10.5005/jp-journals-10032-1096
Volume
5
Issue
1
Publishing Year
2017
Pages
3
Author Affiliations
    1. Department of Obstetrics and Gynecology, Chennai Medical College Hospital & Research Centre, Tiruchirappalli, Tamil Nadu, India
  • Article keywords

    Abstract

    Introduction

    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.

    Aims

    To determine the feasibility and outcome of nondescent vaginal hysterectomy (NDVH) and to assess the pre- and postoperative complications, duration of surgery, and hospital stay.

    Materials and methods

    A prospective observational study was conducted between 2012 and 2014 at a tertiary care center. A total of 256 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. The NDVH was performed by the standard technique, and the following parameters of age, parity, indication for surgery, duration of surgery, intraoperative and postoperative complications, and hospital stay were recorded. The data were analyzed using Statistical Package for the Social Sciences version 16.0 by frequency and percentage analysis and Chi-square test.

    Results

    All 256 patients were analyzed. The mean age was 44.4 ± 6.1 years; fibroid uterus was the commonest indication. About 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 numerical rating scale pain scale was 3.0 ± 0.3. Intraoperative blood transfusion was required in 1.9% of the patients only.

    Conclusion

    The NDVH is a safe and feasible procedure for benign gynecological disorders.

    Clinical significance

    The NDVH is a boon in this techno-savvy era by reducing the morbidity and promising early return to work.

    How to cite this article

    Vembu R, Dharmalingam S. Hysterectomy by Vaginal Route: Not a Pressure. J South Asian Feder Menopause Soc 2017;5(1):8-10.

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