Publication:

Comparative analysis of patient profile, intraoperative characteristics and postoperative outcomes of two routes of hysterectomy: non descent vaginal hysterectomy and total abdominal hysterectomy

Background Worldwide, hysterectomy is the most common non–pregnancy related major surgery performed on women. In the past, uterine prolapse was the major indication for vaginal route of hysterectomy. However, recently, the applicability of this route has expanded to other common benign gynaecological disorders without uterovaginal descent giving way to non-descent vaginal hysterectomy (NDVH). The purpose of this study was to compare the two routes of hysterectomy: NDVH and TAH.

Methods The prospective observational study compared fifty cases each undergoing NDVH and TAH respectively for benign gynaecological disorders. Data was statistically analyzed to find out the level of significance between various factors of the two groups.

Results Most common indication for performing hysterectomy was uterine fibroid (62%). Large size uteri were removed vaginally by use of complementary techniques. A statistically significant difference was observed in the mean post-operative haemoglobin (p=0.03) and percentage drop in haemoglobin (p=0.000) in the two groups. Mean residual pain percentage was more for TAH group (p=0.000), thereby this group required greater number of doses of injectable analgesics (p=0.000). Duration of catheterization was more for TAH group. The NDVH group showed a faster tolerance to normal diet (p=0.000) with a faster resumption of normal routine activities (p=0.000).

Conclusions Hysterectomy should always be performed by the least invasive and most economical route and NDVH should be a gynecologist’s first choice in cases with benign gynaecological disorders.