Pradeep S1, Beeresh C. S2, L. Krishna3, Vimala K. R4, Shailaja N5, Pallavi P6, Divyashree7
OBJECTIVE: To evaluate the role of non-descent vaginal hysterectomy in advancing gynaecological practice and to study the safety and feasibility of performing vaginal hysterectomy for non-prolapsed uterus as primary route in benign gynaecological condition.
METHODS: A prospective study of 120 cases was conducted at the department of obstetrics and gynaecology of PES institute of medical sciences and research from January 2012 to December 2014 120 patients planned for hysterectomy for a wide range of benign indications like fibroid uterus, AUB, adenomyosis were chosen for non-descent vaginal hysterectomy. Data regarding age, parity, uterine size, and estimated blood loss, length of operation, intra-operative and post-operative complications and hospital stay were recorded.
RESULTS: A total of 120 cases were selected for non-descent vaginal hysterectomy. Among them 113(94.16%) cases successfully underwent non-descent vaginal hysterectomy. Majority were aged 40 - 45 years (53.33%) with 8 nullipara and 21primipara. Commonest indication was fibroid (58%) and largest uterine size was 16 weeks. Different morcellation techniques were used in more than 10weeks sized uterus. Adnexal surgeries were performed in 11 cases without much difficulty. In uncomplicated cases average blood loss was 200 ml and operating time was 60minutes. Most of the patients were discharged by 4th post-operative day, 7 patients were converted to abdominal route due to various difficulties, 3 patients had bladder injury and 1 patient was subjected to laparotomy due to hemoperitoneum post operatively.
CONCLUSION: Proper training and proper case selection can lead a gynecologist to consider the vaginal approach as the standard route for hysterectomy and good patient compliance
