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

Abstract

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.

Laparoscopically assisted vaginal hysterectomy vs non-descent vaginal hysterectomy in the benign diseases of the uterus: an interventional study

“…In this study most of the patients for surgery happened to be of the common age group of 41 to 50 years and similar was noticed by Chang well. 3,4,10 The average parity happened to be 3 in LAVH group whereas in NDLH it was 2, which commensurates with the respective groups of the study conducted by Goswami et al and Shiragur et al 6,9 In this study, most common cause to force surgery in these two groups (LAVH 28.8% and 26.9% NDVH) were fibroid uterus of size 12-14 weeks or less, followed by adenomyosis (23.1% LAVH and 26.9% NDVH ) which is in sync with the study conducted by Shiragur et al 9 Whereas Goswami et al observed leiomyoma as the most prevalent indication for LAVH (32.5%) and AUB for the NDVH group (37.9%). 7 Despite the same team of surgeon performing both the procedures, the average period of surgery in NDVH in the absence of debulking was 90.54±5.89 min.…”

“…Soren et al reported a period of 65.44 min and that of Shiragur et al was100-200 min 10. For LAVH group the mean duration was 127.12±12.58 min which was comparatively longer than NDVH.…”