Publication:

Comparative study of non-descent vaginal hysterectomy and laparoscopy assisted vaginal hysterectomy

Background We aimed to assess and compare intra operative and post-operative parameters and complications associated with non-descent vaginal hysterectomy group (NDVH) and laparoscopic assisted vaginal hysterectomy group (LAVH).

Methods In this observational study 100 patients with uterine size not exceeding 12 weeks of gravid uterus, adequate uterine mobility, fibroid uterus, dysfunctional uterine bleeding, chronic cervicitis, adenomyosis and post-menopausal bleeding were divided into two groups to undergo either NDVH and LAVH. Their intra-operative and post-operative parameters were compared.

Results The mean operating time was significantly less in NDVH group as compared to LAVH group cases (65.44 vs 83.12 mins; p<0.01). Blood loss (210.22 vs 261.58 ml; p-0.03) during the procedure and drop in haemoglobin (1.22 vs 1.62 gm%; p-0.08) was also lower with NDVH group as compared to LAVH group respectively. Requirement of blood transfusion, adnexotomy and incidence of anaesthesia related complications were similar between the two study groups. Median VAS score was significantly less in NDVH group as compared to LAVH group at immediate post-op period and at day 1 respectively (p<0.01). We observed a comparable mean hospital stay for the patients in the two study groups (5.52±1.33 vs 6.01±1.39 days, p value=0.71).

Conclusions Based on the results of the present study, we conclude that NDVH is safe and should be offered as the first surgical choice in women with uterine enlargement due to benign pathology and non-prolapsed uterus.