A Comparative Analysis of Nondescent Vaginal Hysterectomy, Laparoscopy-Assisted Vaginal Hysterectomy, and Total Laparoscopic Hysterectomy for Benign Uterine Diseases at a Rural Tertiary Care Center

Abstract

Objectives: The aim of this study was to compare operative data and postoperative complications among nondescent vaginal hysterectomy (NDVH), laparoscopy-assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH) at a rural tertiary care center. Materials and Methods: This is a prospective analytical study, of 145 hysterectomies for benign conditions with or without salpingo-oophorectomy in women from 30 to 60 years, over 3 years from January 2016 to December 2019, with 60 cases of NDVH, 46 cases of LAVH, and 39 cases of TLH. The three groups were compared intraoperatively in terms of blood loss, operating time, and intraoperative complications and postoperative complications and postoperative duration of hospital stay. Results: There was no significant difference between the three groups in terms of age, parity, body mass index, and indications for hysterectomies. The mean operative time was significantly shorter ( P = 0.000) in the NDVH group (54.67 ± 15.67 min) as compared to the LAVH (102.45 ± 10.53 min) and TLH (126.79 ± 8.7 min) groups. Intraoperative blood loss was greater ( P = 0.000) in the TLH group (111.025 mL ± 20.8) as compared to the NDVH (59.50 mL ± 16.7) and LAVH (91.85 mL ± 10.66) groups. The intraoperative complications and postoperative complications were higher in the TLH group as compared to the LAVH and NDVH groups. The duration of hospital stay was almost similar in all the groups. Conclusion: NDVH may be the preferred approach for experienced surgeons, as it is less time-consuming, has a small amount of blood loss, and is a scarless surgery, whereas LAVH and TLH may be the preferred approaches in the cases of presence of adnexal masses and adhesions or whenever salpingo-oophorectomy is indicated.

Effects of smokeless tobacco on the uterine wall of adult non pregnant female swiss albino rats

“…The mean weight of the uterus was 82.7 ± 45.1 grams. The study found no substantial changes in the weight of the uterus between women of different age groups or parity (9). Another study conducted by Octaviana et al examined hormonal levels in 100 women with irregular menstrual cycles.…”

“…One study that investigated the weight of the uterus in Pakistani women measured the weight of the uterus in 126 women who underwent hysterectomy for benign conditions (9). The mean weight of the uterus was 82.7 ± 45.1 grams.…”

Surgical Morbidity of Laparoscopic Hysterectomy versus Abdominal Hysterectomy: A Retrospective Overview

“…The surgical approach many at times form the determining factor for postoperative surgical morbidity in patients especially in cases of abnormal uterine bleeding which is considered a diagnosis of exclusion. [ 8 9 ] It accounts for most of the referrals to the gynecological outpatient department and in the majority of patients, no organic pathology is identified that which makes it difficult to convince patients to medical management and follow-up, thus preferring surgical management as their ultimate solution. [ 10 ] The studies done previously have demonstrated a dependence of surgical morbidity not only on the surgeon’s degree of experience with the respective laparoscopic operation but also on the amount of experience with endoscopic procedures of the entire treating center.…”

Four-step Technique on Ureteral Safety in Total Laparoscopic Hysterectomy

“…Total laparoscopic hysterectomy (TLH) significantly increases ureteral injury risk compared to open abdominal hysterectomy. [ 1 2 3 ] In difficult cases, ureter dissection is important for preventing ureteral injury. [ 4 ] Dissecting the ureter is not always needed; however, in complicated cases, it is difficult for residents.…”